Sildenafil may help to minimise erectile dysfunction associated with prostate cancer treatment. Studies in men treated with external beam radiotherapy suggest that it can help improve potency (24), (25), (26).
A study of men who were treated with brachytherapy showed a significant improvement in erectile function among men who started using sildenafil within a year of treatment, compared with those who waited longer than a year (27).
Studies looking at sildenafil use after prostatectomy suggest that its efficacy depends upon the presence of neurovascular bundles. Men who had nerve-sparing surgery responded better to sildenafil than those who had non-nerve sparing surgery (28).
As the current data is based on small trials, this subject needs further evaluation.
A 3-year follow up to evaluate the long-term effect and safety of sildenafil for the treatment of erectile dysfunction after radical prostatectomy demonstrated that 31 (71%) of the 43 patients were still responding to sildenafil at 3 years (29).
Other treatment options that can be helpful in improving potency include tadalafil (Cialis®), vardenafil (Levitra®), apomorphine sublingual tablets (Uprima®), alprostadil pelets (MUSE), penile injections of alprostadil (Caverject®, and Viridal®) or papaverine and vacuum pumps.