Cialis (Effectiveness in Men After Postprostatectomy)
ED is a frequent complication of radical prostatectomy. Despite improvements
in surgical techniques used in prostatectomy, trauma to neurovascular
bundles leaves many patients with ED. In fact, more than 50% of patients
who undergo prostatectomy procedures will have ED. In one study, the
effects of tadalafil were examined in men who had developed ED after
bilateral nerve-sparing radical retropubic prostatectomy (BNRRP). After a
4-wk no-treatment baseline period, patients received 20 mg of tadalafil or
placebo as needed for the next 12 wk. Patients who received tadalafil had
significantly improved EF, with a five-point increase in scores for the
EF domain of the IIEF (compared with a one-point increase for placebo
[p < 0.001]). (An increase of just five points in the IIEF EF domain is consistent
with an improvement, such as moving from severe to moderate ED
or from moderate to mild ED). By the end of the 12-wk treatment period, the
group of all randomized patients receiving 20 mg of tadalafil after BNRRP
had significantly better rates of successful intercourse attempts (41%) than
those receiving placebo (19%) (p < 0.001) (Fig. 7). All randomized patients responded positively to the GAQ (62% with
20 mg of tadalafil vs 23% with placebo; p < 0.001). Additionally, encouraging
results for patients with this type of ED were observed in a subgroup
of men who exhibited at least some erection or tumescence at baseline and
experienced an even better response to tadalafil than subjects in a separate
study. Another study showed that after nerve-sparing surgery, the highest
dose of a PDE5 inhibitor, such as tadalafil, is usually the most efficacious
dose, and that best results are seen 12 mo after surgery.
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