Phosphodiesterase type-5 inhibitors for the treatment of erectile dysfunction after prostate surgery: A review

This study reviewed the best phosphodiesterase type 5 inhibitors (PDE5is) for the treatment of erectile dysfunction (ED) after prostate surgery. Researchers suggested that avanafil (Spedra) might be the best PDE5i drug for these patients.

Prostate cancer is one of the most common cancers in the elderly population. ED is common among these patients after prostate surgery. Despite the several available ED treatments, the most common treatment is PDE5i drugs. Although, studies have shown that PDE5is have less effectiveness in patients with ED after prostate surgery when compared to the general population.

However, it is still not clear which treatment strategy is the best in clinical practice for men with ED after prostate surgery.

This study reviewed 14 other studies with information about patients with ED after prostate surgery. All participants received treatment with different PDE5i agents including tadalafil (Cialis), vardenafil (Levitra), sildenafil (Viagra), or avanafil. 

Patients who received treatment with PDE5is followed by nerve-sparing prostate surgery had a 2.67 times higher likelihood to have an improvement in sexual function. Taking a PDEi drug when needed before sexual intercourse was associated with the best benefit.

Avanafil (200 mg) was associated with a 4.72 times higher improvement compared to placebo likely the best treatment option. This was followed by sildenafil with a 3.36 times higher chance, tadalafil with a 2.34 times higher chance, and vardenafil with a 2.07 times higher chance of improvement compared to placebo.

This study concluded that avanafil 200 mg might be the best treatment option for patients with ED after prostate surgery. 

This study was based on results from multiple studies. The questionnaires that evaluated sexual function were not the same in all studies. This might affect the results.