Acceptance of and Discontinuation Rate from Erectile Dysfunction Oral Treatment in Patients following Bilateral Nerve-Sparing Radical Prostatectomy

Andrea Salonia, Andrea Gallina, Giuseppe Zanni, Alberto Briganti, Federico Dehò, Antonino Saccà, Nazareno Suardi, Luigi Barbieri, Giorgio Guazzoni, Patrizio Rigatti, Francesco Montorsi

Research output: Contribution to journalArticle

Abstract

Objectives: Assess acceptance of and discontinuation rate from erectile dysfunction (ED) treatment in patients after bilateral nerve-sparing radical retropubic prostatectomy (BNSRRP). Methods: We analyzed acceptance and discontinuation data of 100 consecutive, age-comparable, preoperatively self-reported potent BNSRRP patients who at the discharge from the hospital received a phosphodiesterase type 5 inhibitor (PDE5-I) prescription. Patients were informed of the pharmacokinetic properties of the available compounds and the option of on-demand versus rehabilitative therapy. Thereafter, patients did not receive any specific counseling throughout the entire follow-up period and freely decided to use or not use any ED therapy. Complete preoperative data were obtained on hospital admission and included a medical and sexual history and the International Index of Erectile Function (IIEF). The IIEF was completed every 6 mo postoperatively, and patients participated in a semi-structured interview about the treatment adherence at the 18-mo follow-up. Results: Forty-nine (49%) patients freely decided not to start any ED therapy (group 1). Of the remaining patients, 36 (36%) opted for an as-needed PDE5-I (group 2), whereas 15 (15%) decided to use a daily PDE5-I (group 3). At the 18-mo follow-up, the overall discontinuation rate from both treatment modalities was 72.6% (eg, 72.2% vs. 73.3% in group 2 vs. group 3; p = 0.79). Treatment effect below expectations was the main reason for treatment discontinuation, followed by loss of interest in sex due to partner's causes. Conclusions: Almost 50% of BNSRRP patients freely decided not to start any ED treatment postoperatively. Roughly 73% of patients who started therapy eventually discontinued it.

Original languageEnglish
Pages (from-to)564-570
Number of pages7
JournalEuropean Urology
Volume53
Issue number3
DOIs
Publication statusPublished - Mar 2008

Keywords

  • BNSRRP
  • Erectile dysfunction
  • PDE5 inhibitors
  • Prostate cancer
  • Radical prostatectomy
  • Therapy
  • Treatment

ASJC Scopus subject areas

  • Urology

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