Sildenafil citrate after radical retropubic prostatectomy

Purpose: Erectile dysfunction continues to be a significant problem for men after radical retropubic prostatectomy despite nerve sparing techniques. S ildenafil citrate (Viagra double dagger) has proved effective for erectile dysfunction in many men. We determine the efficacy of sildenafil in men wit h erectile dysfunction after radical retropubic prostatectomy and examine v ariables that may impact, the response to treatment. Materials and Methods: A total of 84 men were prescribed sildenafil after r adical retropubic prostatectomy and asked to complete a series of questionn aires, including the International Index of Erectile Function (IIEF), on er ectile function before and after sildenafil administration. The importance of factors, such as patient age, time since surgery, degree of cavernous ne rve sparing, preoperative prostate specific antigen, Gleason score, clinica l and pathological stage, and baseline postoperative erectile function, was examined. Results: Of the 84 patients 45 (53%) had improved erections and 34 (40%) ha d improved ability for intercourse while taking sildenafil. Mean IIEF score for the erectile function domain increased from 9 to 14 (p < 0.001). Orgas mic function (p = 0.004) and intercourse satisfaction (p = 0.009) also sign ificantly improved. The degree of nerve sparing and baseline postoperative erectile dysfunction had a significant impact on the ability of sildenafil to improve erectile function (p = 0.010 and p <0.001, respectively) and tot al IIEF questionnaire responses (p = 0.031 and p <0.001, respectively). Age and pathological stage also appeared to have a significant effect. Conclusions: Sildenafil improved erectile function and the ability to have intercourse in more than half of men after radical retropubic prostatectomy . Baseline postoperative erectile function, which is dependent on the degre e of nerve sparing technique, significantly impacts the likelihood that pat ients will respond to sildenafil.