Phosphodiesterase (PDE -5 inhibitors) are used for treating erectile dysfunction.PDE -5 inhibitors cause the relaxation of blood vessels in the penis that aids in unnatural erection.However, these medications work only in the presence of adequately functioning nerves when sexual stimulation occurs. The associated side effects include the following:
Headache.
Nose stuffiness
. Facial flushing. Heartburn.
There are available in tablet form and include the following:
Cialis (Tadalafil).
Viagra(Sildenafil).
Levitra (Vardenafil).
To obtain the required result,the medication should be taken for a minimum of three months regularly. Cialis (Tadalafil) has a longer duration of action, andusually, a dose of 20 mg is given thrice a week. Viagra (Sildenafil) is to be taken daily, and the dosage range from 25 to 50 mg. Levitra (Vardenafil) is taken thrice weekly, and its effects last for around 24 hours.
When to Start Penile Rehabilitation and What Are the Different Rehabilitation Programs?About two months after prostatectomy surgery,the patient discusses the sexualfunction with the Cancer specialist nurse and undergoes penile rehabilitation if needed. The sooner the repair is started, the better. The different penile rehabilitation programs include the following:
1. Phosphodiesterase (PDE- 5inhibitors):
Phosphodiesterase(PDE-5 inhibitors) are usedas first-line therapy except when the patientis under nitratemedication for angina or other conditions. This is because PDE-5
3. Intracavernosal Injections:
Intracavernosal Injections(ICI) are used as first-line therapy in patients who have undergone non-nerve-sparing prostatectomy. They are also used in cases where the patient does not respond to PDE inhibitors and where PDE inhibitors are contraindicated.
This injection causes smooth muscle relaxation and dilatati on of arteries, increasing oxygen-rich blood flow to the penile region. This causes blood trapping within the corpus cavernosa, resulting in an erection.
The cancer specialist nurse will provide the dosage and instructions on using the injection. The usual dose is to be administered thrice weekly, the erection lasts 45 minutes,and the penis returns to normal in two hours.
The complications associated with ICI include the following:
Scar tissue development.Priapism - A long-lasting painful erection lasting more than two hours without sexual stimulation.If a painful erection lasts more than three hours (priapism), immediate medical attention is required.
4. Penile Prosthesis:
The medical team will give the instructions for doing pelvic floor exercises, and the patient is advised to start exercising asso on as possible. These exercises increase the tone of pelvic floor muscles and blood flow to the region, thus contributing to faster healing.
5. Intraurethral Alprostadil (Muse):
Intraurethral Alprostadil (Muse) is applied to the urethra. The medication dissolves and gets absorbed locally and benefits in achieving an erection that is sufficient to produce penetrative intercourse.
Conclusion
Following prostatectomy, the main problem faced is erectile dysfunction. Two months post-surgery penile rehabilitation program sare started for correcting erectile dysfunction. The earlier it is started, the better. The patient is provided with personalized programs under the guidance of the physician and specialist nurse. PDE inhibitors are give nas first-line.