Efficacy and safety of avanafil 200 mg versus sildenafil 100 mg in the treatment of erectile dysfunction after robot-assisted unilateral nerve-sparing prostatectomy: A prospective multicentre study. Issue 1 (February 2020)

• Record Type: Journal Article
• Authors: Della Camera, Pier Andrea; Tellini, Riccardo; Cito, Gianmartin; Rastrelli, Giulia; Maggi, Mario; Chini, Tommaso; Nunzio, Cosimo De; Altieri, Vincenzo Maria; Serni, Sergio; Gacci, Mauro; Natali, Alessandro
• Is Part Of: Urologia journal. Volume 87:Issue 1(2020)
• Page Start: 23
• Page End: 28
• Publication Date: 2020-02
• Subjects: Erectile dysfunction -- prostatectomy -- rehabilitation -- avanafil -- sildenafil -- impotence; Urology -- Periodicals; 616.6005
• DOI: 10.1177/0391560319867809
• Languages: English
• ISSNs: 0391-5603

Abstract

Phosphodiesterase type 5 inhibitors represent the standard treatment of erectile dysfunction after nerve-sparing prostatectomy. Avanafil is a second-generation phosphodiesterase type 5 inhibitor with a high selectivity for phosphodiesterase type 5 isoform. To date, there are no studies comparing the outcomes of avanafil versus sildenafil in this scenario. In this study, we evaluated the efficacy and safety of avanafil versus sildenafil as a drug for post-prostatectomy rehabilitation. Overall, 160 patients submitted to robot-assisted nerve-sparing prostatectomy for localized prostate cancer at three hospitals were enrolled for the present study. After 6 months of treatment, patients in the two groups showed no significantly different sexual function scores, except for the Erection Hardness Score and Sexual Encounter Profile-Q2 that were higher in the Sildenafil group. Adverse events in the Avanafil group occurred in four (5%) patients and in 16 (20%) patients in the Sildenafil group. According to our experience, in patients undergoing nerve-sparing prostatectomy, penile rehabilitation with avanafil compared to sildenafil showed a lower ability to produce a valid erection in the initial phase of sexual intercourse, a difference that disappears in the continuation of the same. Avanafil showed a greater tolerance profile with a lower rate of AEs and discontinuation of therapy due to AEs.