Yes. Erectile dysfunction following bilateralnerve sparing retropubic radical prostatectomy results from smooth muscle degeneration secondary to neurapraxia and hypoxia [38]. Even with nerve-sparing surgical techniques, nerve injury may result from the unintentional surgical severing of nerve tissue, nerve stretching during prostate retraction, thermal or ischemic injury to nerves, or local inflammatory effects. [39] Tadalafil 20 mg has been shown to improve erectile function in men following bilateral nerve-sparing radical retropubic prostatectomy (BNSRRP) [40]. The mean percentage of successful intercourse attempts (SEP3) was41% formen taking tadalafil compared to 19% on placebo (p < 0.001). The improvements in IIEF, SEP, and GAQ scores were higher overall for a subgroup of men with evidence of tumescence ability after prostatectomy (i.e., less severe ED). This study evaluatedmenwhohadED12–48months post-surgery. PDE5 inhibitor therapy administered on a daily basis within 30 days of radical prostatectomy is being studied to determine if this facilitates the earlier return of erectile function.
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