Tags

Type your tag names separated by a space and hit enter

Return of nocturnal erections and erectile function after bilateral nerve-sparing radical prostatectomy in men treated nightly with sildenafil citrate: subanalysis of a longitudinal randomized double-blind placebo-controlled trial.
J Sex Med. 2008 Feb; 5(2):476-84.JS

Abstract

INTRODUCTION

After bilateral nerve-sparing radical retropubic prostatectomy (BNSRRP), nocturnal and sexually mediated erections may help to preserve normal erectile function (EF).

AIM

To investigate nocturnal penile tumescence and rigidity (NPTR) in a subset (N = 54 men) from a randomized, double-blind trial (N = 76) of nightly sildenafil after BNSRRP.

METHODS

Inclusion required preoperative "normal" EF (defined as a combined score of >/=8 for International Index of Erectile Function questions 3 (penetration) and 4 (maintained erection after penetration) and NPTR testing (>/=10 continuous minutes of >/=55% rigidity [R >/= 55%] at the base). Postoperative assessments were at weeks 4 (pretreatment), 16, 28, 40 (during 36 weeks of nightly prophylaxis: sildenafil 50 mg [N = 17], 100 mg [N = 18] or placebo [N = 19]), and 48 (after 8 weeks of no erectile dysfunction therapy, when "responders" were delineated by the defined normal EF and a "yes" response to "Over the past 4 weeks, have your erections been good enough for satisfactory sexual activity?"). Base and tip rigidity and tumescence were measured using penile plethysmography.

MAIN OUTCOME MEASURES

Duration of R >/= 55% and area under the curves for rigidity and tumescence.

RESULTS

Postoperatively, rapid profound reduction in nocturnal EF was noted in all groups. There was a gradual dose-dependent improvement in base and tip rigidity in the sildenafil groups but little improvement in the placebo group. Eight weeks after treatment termination (48 weeks postoperatively), 24% (4/17) of 50-mg sildenafil recipients, 33% (6/18) of 100-mg sildenafil recipients, and 5% (1/19) of placebo recipients were responders. Tip R >/= 55% was the most discriminating NPTR measure between nonresponders and responders to sildenafil, in whom it regained baseline (preoperative) levels (whereas base R >/= 55% did not). It was most prolonged in responders to sildenafil 100 mg.

CONCLUSIONS

In our subset analysis, nightly sildenafil for 9 months post-BNSRRP objectively improved nocturnal erections and pharmaceutically unassisted EF.

Authors+Show Affiliations

New York University Medical Center-Urology, New York, NY, USA. andy.mccullough@nyumc.orgNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18086170

Citation

McCullough, Andrew R., et al. "Return of Nocturnal Erections and Erectile Function After Bilateral Nerve-sparing Radical Prostatectomy in Men Treated Nightly With Sildenafil Citrate: Subanalysis of a Longitudinal Randomized Double-blind Placebo-controlled Trial." The Journal of Sexual Medicine, vol. 5, no. 2, 2008, pp. 476-84.
McCullough AR, Levine LA, Padma-Nathan H. Return of nocturnal erections and erectile function after bilateral nerve-sparing radical prostatectomy in men treated nightly with sildenafil citrate: subanalysis of a longitudinal randomized double-blind placebo-controlled trial. J Sex Med. 2008;5(2):476-84.
McCullough, A. R., Levine, L. A., & Padma-Nathan, H. (2008). Return of nocturnal erections and erectile function after bilateral nerve-sparing radical prostatectomy in men treated nightly with sildenafil citrate: subanalysis of a longitudinal randomized double-blind placebo-controlled trial. The Journal of Sexual Medicine, 5(2), 476-84.
McCullough AR, Levine LA, Padma-Nathan H. Return of Nocturnal Erections and Erectile Function After Bilateral Nerve-sparing Radical Prostatectomy in Men Treated Nightly With Sildenafil Citrate: Subanalysis of a Longitudinal Randomized Double-blind Placebo-controlled Trial. J Sex Med. 2008;5(2):476-84. PubMed PMID: 18086170.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Return of nocturnal erections and erectile function after bilateral nerve-sparing radical prostatectomy in men treated nightly with sildenafil citrate: subanalysis of a longitudinal randomized double-blind placebo-controlled trial. AU - McCullough,Andrew R, AU - Levine,Laurence A, AU - Padma-Nathan,Harin, Y1 - 2007/12/14/ PY - 2007/12/19/pubmed PY - 2008/5/23/medline PY - 2007/12/19/entrez SP - 476 EP - 84 JF - The journal of sexual medicine JO - J Sex Med VL - 5 IS - 2 N2 - INTRODUCTION: After bilateral nerve-sparing radical retropubic prostatectomy (BNSRRP), nocturnal and sexually mediated erections may help to preserve normal erectile function (EF). AIM: To investigate nocturnal penile tumescence and rigidity (NPTR) in a subset (N = 54 men) from a randomized, double-blind trial (N = 76) of nightly sildenafil after BNSRRP. METHODS: Inclusion required preoperative "normal" EF (defined as a combined score of >/=8 for International Index of Erectile Function questions 3 (penetration) and 4 (maintained erection after penetration) and NPTR testing (>/=10 continuous minutes of >/=55% rigidity [R >/= 55%] at the base). Postoperative assessments were at weeks 4 (pretreatment), 16, 28, 40 (during 36 weeks of nightly prophylaxis: sildenafil 50 mg [N = 17], 100 mg [N = 18] or placebo [N = 19]), and 48 (after 8 weeks of no erectile dysfunction therapy, when "responders" were delineated by the defined normal EF and a "yes" response to "Over the past 4 weeks, have your erections been good enough for satisfactory sexual activity?"). Base and tip rigidity and tumescence were measured using penile plethysmography. MAIN OUTCOME MEASURES: Duration of R >/= 55% and area under the curves for rigidity and tumescence. RESULTS: Postoperatively, rapid profound reduction in nocturnal EF was noted in all groups. There was a gradual dose-dependent improvement in base and tip rigidity in the sildenafil groups but little improvement in the placebo group. Eight weeks after treatment termination (48 weeks postoperatively), 24% (4/17) of 50-mg sildenafil recipients, 33% (6/18) of 100-mg sildenafil recipients, and 5% (1/19) of placebo recipients were responders. Tip R >/= 55% was the most discriminating NPTR measure between nonresponders and responders to sildenafil, in whom it regained baseline (preoperative) levels (whereas base R >/= 55% did not). It was most prolonged in responders to sildenafil 100 mg. CONCLUSIONS: In our subset analysis, nightly sildenafil for 9 months post-BNSRRP objectively improved nocturnal erections and pharmaceutically unassisted EF. SN - 1743-6109 UR - https://www.unboundmedicine.com/medline/citation/18086170/Return_of_nocturnal_erections_and_erectile_function_after_bilateral_nerve_sparing_radical_prostatectomy_in_men_treated_nightly_with_sildenafil_citrate:_subanalysis_of_a_longitudinal_randomized_double_blind_placebo_controlled_trial_ DB - PRIME DP - Unbound Medicine ER -