Jun
06

Unilateral Vs. Bilateral Nerve Sparing and ED

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A new study reinforces what we already know: that the Viagra family of drugs work for a lot of PC patients (I think it’s about 50%).  However, you will not get results from these drugs if the erectile nerves are damaged beyond a certain point.  If you are taking Viagra after RP and are not getting results within about two months, you probably won’t get any results — at least for a time.  You should try again in about 9 months when the nerves have had a chance to heal.   If you take Viagra in the interim, you will unwittingly be “donating money to the drug companies”, in the words of my husband’s famous ED doc.  (For more info, see roboticoncology.com.)

*What makes this study interesting is that the researchers found no difference in function between men who had unilateral and bilateral nerve sparing.*  I recommend that every man who has had RP order a copy of his “Operative Report” where this information is listed — you might get a surprise.  Husb’s doc told us he had spared both nerves.  But the Op Report read: “Nerve bundles have been excised on the left side”.  So whom do you believe?

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 UroToday, June 5, 2008

Phosphodiesterase Type 5 Inhibitors in the Management of Erectile Dysfunction Secondary to Treatments For Prostate Cancer: Findings from a Cochrane Systematic Review

A group from the UK led by Bridget Candy report a meta-analysis in the BJU International on phosphodiesterase type 5 inhibitors (PDE5i) for the treatment of erectile dysfunction (ED) secondary to treatments for prostate cancer (CaP). [Note: PDED5 inhibitors include Viagra, Levitra (vardenafil) and cialis (tadalafil.)]

Two trials evaluated the effects of sildenafil, 2 tadalafil and one vardenafil.  Most were at the highest recommended doses of these drugs. In all trials the PDE5i drugs were significantly favored over placebo. <snip>  All trials had reported side effects, most commonly dyspepsia, flushing, headache, nausea and rhinitis.

<snip In one trial, the effectiveness of the PD5i by dosage and unilateral vs. bilateral nerve sparing radical prostatectomy found no difference.

Candy B, Jones L, Williams R, Tookman A, King M

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