Introduction: Several strategies are published for postoperative erectile function rehabilitation after nerve-sparing radical prostatectomy (nsRP). The aim of our study was to evaluate the use of any ED-treatment or the adherence to study protocol medication 3 years after the end of the initiated rehabilitation program.
Methods: 124 patients (mean age 69 years) from 3 different rehabilitation studies after nsRP with a regular dose of different PDE5-inhibitors (sildenafil/vardenafil/tadalafil) were enrolled for this evaluation. The regular initial follow-up of all of the 3 studies was 24 months. We performed a questionnaire sent to all enrolled patients of these studies 3 years after the end of the study / 5 years after nsRP. The survey consists of different questions, e.g. if and what kind of ED-treatment the patients still use. Further questions dealt with the reasons to end the study medication or switch to any other treatment.
Results: 99 patients (79.8%) completed and returned the questionnaire. 51 patients (52%) had stopped medical ED-treatment therapy completely at the time of the survey because of different reasons (completely restored erectile function without any medication 11%, subsequent ineffectiveness of the medication 8%, progressive disease of prostate cancer 7%, subsequent comorbidities 25%). From the remaining 48 patients only 21 patients (21%) still using only PDE5-inhibitors (daily or on demand). 16 patients (16%) using penile injection therapy, 3 patients MUSE (3%) and 8 patients VCD (with/without PDE5-inhibitors) (8%).
Conclusions: 5 years after nsRP / 3 years after the end of the different rehabilitation studies most of the patients (52%) don´t use any ED-medication anymore due to different reasons. Only 11% of the patients after being enrolled in rehabilitation programs for 24 months are still reporting a restored erectile function 5 years after nsRP without any medication.