Effect Of Epimedium Combined With Low Dose Tadalafil In The Treatment Of Erectile Dysfunction After Prostate Surgery

Objective:Epimedium is one of the main components of many Chinese patent medicines,it has been used in aphrodisiac for more than two thousand years.This study compared the efficacy of epimedium combined with low-dose tadalafil and low-dose tadalafil in improving erectile function after prostate surgery,and discussed the application value of epimedium combined with low-dose tadalafil in the treatment of erectile dysfunction after prostate surgery.Methods:Retrospectively,we analyzed the clinical data of patients with erectile dysfunction(ED)after prostate surgery in our hospital from February 2020 to September 2021,including 43 patients with prostate cancer(PCa)who underwent bilateral neuro-sparing radical prostatectomy(BNSRP)and 86 patients who underwent transurethral holmium laser enucleation of prostate(Ho LEP).All patients were divided into experimental and control groups.Patients were divided into experimental group and control group according to the different medications taken for ED,the experimental group take Epimedium combined with low-dose tadalafil,and the control group began to take low-dose tadalafil.The treatment period was 3months.Before and after the treatment,Index of Erectile Function(IIEF-5)score,Erectile Hardness Score(EHS),International Prostate Symptom Score(IPSS),traditional Chinese medicine symptoms(dizziness and tinnitus,impotence,emotional depression,weakness of waist and knee)were evaluated and maximum flow rate(Qmax),the penile hemodynamic parameters levels[end diastolic velocity(EDV),peak systolic velocity(PSV),resistance index(RI)]were measured in the two groups of postoperative Ho LEP ED patients.In the same way,the scores of IIEF-5,EHS,traditional Chinese medicine symptoms(dizziness and tinnitus,impotence,emotional depression,weakness of waist and knee)were evaluated and penile hemodynamic parameters levels(EDV,PSV,RI),was measured in the two groups of postoperative BNSRP ED patients.The adverse reactions of the two groups during treatment were observed.Statistical methods were used to compare the differences of the above indexes between the two groups,and to analyze the efficacy of Epimedium combined with low-dose tadalafil in the treatment of erectile dysfunction after prostatectomy.Results:Among the patients with ED after Ho LEP,IIEF-5 score,EHS score,IPSS score,Qmax and penile blood flow parameters(EDV,RI,PSV)were significantly improved in the two groups after 3 months of treatment compared with those before treatment(P<0.05).Moreover,after 3 months of treatment,the overall IIEF-5 score(16.45±1.74 versus 15.46±1.66,P=0.008),EHS score(2.70±0.46 versus 2.37±0.68,P=0.011),IPSS score(9.65±0.80 versus 10.37±1.04,P=0.001),Qmax(15.35±0.76 versus 14.33±1.73,P= 0.001),EDV(28.63±2.08 versus 27.46±2.00,P=0.010)RI(0.85±0.09 versus 0.78±0.10,P=0.001)and PSV(4.58±0.84 versus 5.22±0.76,P=0.000)were also significantly improved compared with the control group(P<0.05);Among the patients with ED after bnsrp,IIEF-5 score,EHS score and penile blood flow parameters(EDV,RI and PSV)were significantly improved in the two groups after 3 months of treatment compared with those before treatment(P<0.05).Moreover,after 3 months of treatment,the overall IIEF-5 score(15.25±1.29 versus 12.22±1.54,P=0.000),EHS score(2.70±0.47 versus 2.26±0.81,P=0.039),EDV(24.90±1.41 versus 23.35±1.53,P=0.001)and RI(0.76±0.09 versus0.65±0.16,P=0.010)and PSV level(5.50±1.15 versus 6.74±1.29,P=0.002)were also significantly improved compared with the control group(P<0.05).After treatment,the symptoms of dizziness and tinnitus,emotional depression and weakness of waist and knee in the experimental group were significantly improved compared with those before treatment or after treatment in the control group(P<0.05),but there was no significant difference in dizziness and tinnitus,emotional depression and weakness of waist and knee in the control group(P>0.05),and there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:1.Epimedium combined with low-dose tadalafil can not only improve the erectile function after Ho LEP and bnsrp,but also improve the lower urinary tract symptoms after Ho LEP,and the effect is better than that of low-dose tadalafil alone.2.Epimedium combined with low-dose tadalafil can improve the symptoms of waist and knee soreness,enhance the physical fitness of patients,and has good safety.It can be used as a treatment scheme for ED after prostatectomy.