AIM
To evaluate the therapeutic response to various forms of pharmacological treatment in the management of erectile dysfunction in patients submitted to radical prostatectomy for prostatic caracinoma, and thus, on the basis of the results obtained, set up a protocol in the attempt to standardize the therapeutic approach.
Materials and Methods
The study population comprised 132 patients presenting erectile 
dysfunction following radical prostatectomy. Patients were divided into 3 groups: group l - submitted to self intra-cavernous injection of alprostadil, either alone or associated with phentolamine and/or papaverine; group 2 - following a cycle of self intra-cavernous injection, received sildenafil; group 3 - following a cycle of self intra-cavernous injection, received tadalafil. Follow-up lasted for 6 months.
Results
At the end of the 6-month treatment period, in group 1 (68 patients), 81% showed a positive response; in group 2 (42 patients), 51% showed a positive response; in group 3 (22 patients), 68% showed an excellent response, with return of spontaneous erections.
Conclusions
Self intra-cavernous injection in the management of erectile dysfunction following radical nerve sparing prostatectomy, for prostatic carcinoma, leads to excellent results but is not well accepted by patients who prefer oral treatment. Tadalafil, a selective inhibitor of PDE 5, guarantees an excellent return of spontaneous erections on account of the longer half life and fewer side-effects.
G. Alei, P. Letizia
University of Rome “La Sapienza” Rome, Italy
