PMID- 24618671
OWN - NLM
STAT- MEDLINE
DCOM- 20150529
LR  - 20211021
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 9
IP  - 3
DP  - 2014
TI  - Systematic review and meta-analysis of the use of phosphodiesterase type 5 
      inhibitors for treatment of erectile dysfunction following bilateral 
      nerve-sparing radical prostatectomy.
PG  - e91327
LID - 10.1371/journal.pone.0091327 [doi]
LID - e91327
AB  - Prostate cancer is relatively common cancer occurring in males. Radical 
      prostatectomy (RP) is the most effective treatment for a localized tumor but 
      erectile dysfunction (ED) is common complication, even when bilateral 
      nerve-sparing RP (BNSRP) is performed. Clinical trials have shown varied 
      effectiveness of phosphodiesterase type-5 inhibitors (PDE5-Is) for treatment of 
      post-BNSRP ED, but there remains controversy over the application of this 
      treatment and no formal systematic review and meta-analysis for the use of 
      PDE5-Is for this condition has been conducted. This review was to systematically 
      assess the efficacy and safety of oral PDE5-Is for post-BNSRP ED. A database 
      search was conducted to identify randomized controlled trials (RCTs). The 
      comparative efficacy of treatments was analyzed by fixed or random effect 
      modeling. Erectile function was measured using the International Index of 
      Erectile Function (IIEF), Sexual Encounter Profile (SEP) question-2, 3 and the 
      Global Assessment Question (GAQ). The rate and incidence of adverse events (AEs) 
      were determined. The quality of included studies was appraised using the Cochrane 
      Collaboration bias appraisal tool. Eight RCTs were included in the analyses. 
      PDE5-Is were effective for treating post-BNSRP ED compared to placebo when 
      erectile function was determined using the IIEF score [mean difference (MD) 5.63, 
      95% confidence interval (CI) (4.26-6.99)], SEP-2 [relative risk (RR) 1.63, 95% CI 
      (1.18-2.25) ], SEP-3 [RR 2.00, 95% CI (1.27-3.15) ] and GAQ [RR 3.35, 95% CI 
      (2.68-4.67) ]. The subgroup analysis could find a trend that longer treatment 
      duration, higher dosage, on-demand dosing, sildenafil and mild ED are associated 
      with more responsiveness to PDE5-Is. PDE5-Is were overall well tolerated with 
      headache being the most commonly reported AE. Our data provides compelling 
      evidence for the use of PDE5-Is as a primary treatment for post-BNSRP ED. 
      However, further studies are required to optomize usage parameters (such as 
      dosage and duration of treatment).
FAU - Wang, Xiao
AU  - Wang X
AD  - Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan city, Hubei 
      province, P. R. China.
FAU - Wang, Xinghuan
AU  - Wang X
AD  - Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan city, Hubei 
      province, P. R. China.
FAU - Liu, Tao
AU  - Liu T
AD  - Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan city, Hubei 
      province, P. R. China.
FAU - He, Qianwen
AU  - He Q
AD  - Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan city, 
      Hubei province, P. R. China.
FAU - Wang, Yipeng
AU  - Wang Y
AD  - Department of Anesthesiology, Zhongnan Hospital of Wuhan University, Wuhan city, 
      Hubei province, P. R. China.
FAU - Zhang, Xinhua
AU  - Zhang X
AD  - Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan city, Hubei 
      province, P. R. China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20140311
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Phosphodiesterase 5 Inhibitors)
SB  - IM
MH  - Erectile Dysfunction/*drug therapy/*etiology
MH  - Humans
MH  - Male
MH  - Odds Ratio
MH  - Phosphodiesterase 5 Inhibitors/adverse effects/*therapeutic use
MH  - Prostatectomy/*adverse effects
MH  - Randomized Controlled Trials as Topic
MH  - Treatment Outcome
PMC - PMC3949994
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2014/03/13 06:00
MHDA- 2015/05/30 06:00
PMCR- 2014/03/11
CRDT- 2014/03/13 06:00
PHST- 2013/11/04 00:00 [received]
PHST- 2014/02/09 00:00 [accepted]
PHST- 2014/03/13 06:00 [entrez]
PHST- 2014/03/13 06:00 [pubmed]
PHST- 2015/05/30 06:00 [medline]
PHST- 2014/03/11 00:00 [pmc-release]
AID - PONE-D-13-46119 [pii]
AID - 10.1371/journal.pone.0091327 [doi]
PST - epublish
SO  - PLoS One. 2014 Mar 11;9(3):e91327. doi: 10.1371/journal.pone.0091327. eCollection 
      2014.