Author (year of publication) Study design Type of pelvic cancer surgery Number of patients Penile rehabilitation modality Active drug (dosage) Regimen Duration Outcomes Montorsi et al. (1997) [14 ] PRCT NSRP 30 ICI Alprostadil (2.5–14 µ g) 3 times weekly starting 1 month after surgery 12 weeks Recovery of spontaneous EF Mulhall et al. (2005) [48 ] Prospective controlled nonrandomized trial RP 132 PDE5I or ICI for nonresponders to PDE5I Sildenafil (50–100 mg) and alprostadil Daily oral PDE5I or 3 times weekly ICI for nonresponders 18 months 2.7 times higher spontaneous EF and statistically higher IIEF scores Bannowsky et al. (2008) [49 ] PRCT NSRP 41 PDE5I Sildenafil (25 mg) Nightly low dose starting the day of catheter removal 52 weeks Higher spontaneous EF and statistically higher IIEF scores Padma-Nathan et al. (2008) [50 ] PRCT BNSRP 76 PDE5I Sildenafil (50–100 mg) Nightly starting 4 weeks after surgery 36 weeks Improvement in spontaneous EF and satisfaction Montorsi et al. (2004) [34 , 51 ] PRCT BNSRP 303 PDE5I Tadalafil (20 mg) On demand 12 to 48 months after surgery 12 weeks Statistically higher IIEF scores and higher satisfaction Brock et al. (2003) [52 ] PRCT NSRP 440 PDE5I Vardenafil (10–20 mg) On demand 12 weeks Statistically higher IIEF scores Raina et al. (2006) [100 ] PRCT NSRP 109 VED VED Daily starting two weeks after surgery 9 months Improvement in spontaneous EF, IIEF scores, and satisfaction Raina et al. (2007) [55 ] Prospective controlled nonrandomized trial NSRP 91 Transurethral MUSE (125 or 250 µ g) 3 times weekly starting 3 weeks after the surgery 9 months Recovery of spontaneous EF
Köhler et al. (2007) [57 ] PRCT NSRP 28 VED VED Daily (10 mins) (immediate (1 month) versus delayed (6 months)) 5 months Improvement of EF and preservation of penile length Montorsi et al. (2008) [61 ] PRCT BNSRP 628 PDE5I Vardenafil (10 mg nightly versus 5/20 mg on demand) 10 mg nightly versus 5/20 mg on demand 9 months No difference in IIEF-EF between nightly dosing and on-demand dosing McCullough (2008) [30 ] PRCT NSRP 54 Transurethral versus PDE5I MUSE (125 µ g) versus sildenafil (50 mg) Nightly starting 1 month after the surgery 9 months No differences in recovery
Schwartz et al. (2004) [27 ] Prospective controlled nonrandomized trial NSRP 21 PDE5I Sildenafil (50 mg versus 100 mg) Every other night beginning the day of catheter removal 6 months No loss of smooth muscle in 50 mg and gain of smooth muscle in 100 mg Nandipati et al. (2006) [101 ] Prospective controlled nonrandomized trial NSRP 22 PDE5I and ICI Sildenafil (50 mg) and alprostadil (1–4 µ g) or trimix (20 U) Sildenafil daily and ICI 2-3 times weekly at hospital discharge 6 months Assisted early sexual activity and satisfaction; addition of PDE5I allows lower dose of ICI Zippe et al. (2004) [63 ] Retrospective RC 49 PDE5I Sildenafil (?) Not specified Not specified Successful vaginal penetration in 9% of patients Hautmann et al. (2010) [72 ] Retrospective RC 9 PDE5I Sildenafil (?) Not specified Not specified Partial tumescence in 5/9 patients El-Bahnasawy et al. (2008) [73 ] Prospective nonrandomized trial RC 100 PDE5I Sildenafil (50–100 mg) Daily 4 weeks with 50 mg and then 4 weeks with 100 mg Dose related effect Nishizawa et al. (2011) [78 ] Prospective nonrandomized trial Rectal cancer surgery 49 PDE5I Sildenafil (25 mg) and vardenafil (5 mg) or sildenafil (50 mg) and vardenafil (10 mg) On demand Not specified Improvement in EF in 69% of patients Lindsey et al. (2002) [82 ] PRCT Rectal cancer and inflammatory bowel disease surgery 32 PDE5I Sildenafil (25–50–100 mg) Dose escalation 4 weeks 79% responded to sildenafil, on global efficacy assessment, compared with 17% taking placebo ( )