Bulbocavernosus reflex testing: A preliminary study on the prognostic factors for potency and response to sildenafil citrate after bilateral nerve-sparing radical prostatectomy

Shai Shefi, Manuel Zwecker, Jehonathan H. Pinthus, Yoram Mor, Gabriel Zeilig, Yeheskell Shemesh, Jacob I. Hanani, Gil Raviv

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Erectile dysfunction (ED) following radical prostatectomy is of major concern for both patients and caring physicians. We evaluated the bulbocavernosus reflex latency (BCRL) and amplitude (BCRA) following bilateral nerve-sparing radical retropubic prostatectomy (NS-RRP) to predict the response to sildenafil citrate (SC). Methods: Patients were recruited in our ED clinic following NS-RRP. Exclusion criteria included preoperative significant ED, neurological disease, and nitrates treatment. Patients were defined as non-responders only after four consecutive unsuccessful trials of 100 mg SC. Results: Twenty patients at least 3 months after surgery were included in this study. Five patients (25%) regained spontaneous erections, although insufficient for vaginal penetration. All of them had normal BCRL and normal BCRA as well as good response to 100 mg SC. Three patients (15%) lacked spontaneous erections and had prolonged BCRL with normal BCRA. This subgroup eventually regained erections using SC. Twelve patients (60%) lacked spontaneous erections and had prolonged BCRL and low BCRA. They failed SC trials and achieved erections using intra-cavernosal injections (ICI) of 10 μg PGE1. Conclusions: Neurophysiologic evaluation consisting of BCRL and BCRA was found to be useful in the prediction of the response to SC following bilateral NS-RRP. Patients who do not regain an erection, and have abnormal BCRL and BCRA 6 months after surgery, will probably be SC non-responders and may benefit from ICI. A subset of patients with preserved BCRA and prolonged latencies has been shown to have a better chance to respond to SC.

Original languageEnglish
Pages (from-to)39-45
Number of pages7
JournalInternational Urology and Nephrology
Volume42
Issue number1
DOIs
StatePublished - Mar 2010

Keywords

  • Bulbocavernosus reflex
  • Bulbocavernosus reflex amplitude
  • Bulbocavernosus reflex latency
  • Erectile dysfunction
  • Radical prostatectomy
  • Sildenafil citrate

Fingerprint

Dive into the research topics of 'Bulbocavernosus reflex testing: A preliminary study on the prognostic factors for potency and response to sildenafil citrate after bilateral nerve-sparing radical prostatectomy'. Together they form a unique fingerprint.

Cite this