Topical alprostadil (Vitaros©) in the treatment of erectile dysfunction after non-nerve-sparing robot-assisted radical prostatectomy



The aim of the study is the evaluation of the efficacy and safety of the treatment with topical alprostadil (Vitaros©) in post-robot assisted radical prostatectomy (RARP) rehabilitation therapy of patients with erectile dysfunction (ED).


Seventy-four patients were enrolled and underwent non-nerve-sparing RARP. Inclusion criteria: age <75, preoperatively International Index of Erectile Function (IIEF-5) >16, erection hardness score (EHS) ≥2, weekly sexual intercourse ≥1, affirmative answers to Sexual Encounter Profile Question (SEP-Q) 2 and SEP-Q3, Charlson Comorbidity Index (CCI) ≤5, Eastern Cooperative Oncology Group (ECOG) performance status ≤1, no moderate/severe cardiovascular disease.


Vitaros was administered ≥2 twice a week. At month 6, the IIEF-5 decreased from 20.5 preoperative to 18.1 post-treatment. EHS score decreased from a mean of 3.3 to a mean of 3.0. The quality of life score decreased from an average of 5.1 to 2.3. Weekly sexual intercourse decreased from an average of 2.1 to 1.7. Six patients dropped out; 89.7% patients showed a positive SEP-Q2 and 77.8% a positive SEP-Q3. All patients responded positively to Global Assessment Questions (GAQ)-1 and 97% to GAQ-2. Of all 68 analyzed patients, 13 (17.6%) switched to intracavernous injection therapy.


In conclusion, Vitaros may become a viable alternative to common injective therapies in well-selected patients after RARP.

In press - Corrected proof




Pier Andrea Della Camera, Simone Morselli, Gianmartin Cito, Giovanni Tasso, Nicola Laruccia, Andrea Cocci, Antonio Ruffo, Mauro Gacci, Sergio Serni, Marco Carini, Alessandro Natali

Article History


Financial support: No grants or funding have been received for this study.
Conflict of interest: None of the authors has financial interest related to this study to disclose.

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  • Department of Urology, Careggi Hospital, University of Florence, Florence - Italy
  • Department of Urology, Santa Maria delle Grazie Hospital, Pozzuoli, Napoli - Italy

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