A study evaluated the effects of the early use of Alprostadil ( Muse ) urethral suppository on erectile dysfunction ( ED ) subsequent to a bilateral nerve-sparing radical prostatectomy ( RP ) in men with prostate cancer.
A total of 91 preoperatively sexually active patients who developed erectile dysfunction due to a bilateral nerve-sparing radical prostatectomy were enrolled in the study.
A single surgeon performed the radical prostatectomy for all study patients.
Fifty-six patients were treated with Alprostadil, three times per week for six months.
Treatment was initiated approximately three weeks after surgery with 125 mcg of Alprostadil; after 6 weeks, the dose of Alprostadil was either increased to 250 mcg or was maintained at 125 mcg for an additional 4 months.
The remaining 35 patients received no treatment and comprised the control group.
Both groups had similar baseline levels of erectile function before surgery.
Thirty-eight patients in the Alprostadil-treated group continued treatment for the duration of the study, and of these, 39% were able to achieve natural erections sufficient for intercourse without the use of erectogenic agents. In contrast, only 11% of subjects in the observational control group were able to achieve erections sufficient for intercourse without treatment six months after surgery.
Erectile function was assessed before and at six months after surgery in both groups using the Sexual Health Inventory for Men ( SHIM ), a patient questionnaire that determines the degree of erectile dysfunction in which higher scores indicate better function.
The six-month SHIM scores for the Alprostadil-treated group was 18.9 ( baseline of 21.2 ) compared to the score of 12.1 ( baseline of 22.0 ) for the control group ( p