87 centres across Europe, the US, Canada and South Africa participated between December 2004 and September 2007.
Nerve-sparing radical prostatectomy (NSRP) is the gold-standard therapy for prostate cancer in men with a life expectancy of 10 years or more. The risk of erectile dysfunction (ED) following NSRP is significant. This is caused by neuropraxia - the usually temporary failure of nerve conduction in the absence of structural changes due to compression, ischemia or blunt injury - which inevitably occurs during the procedure. Ultimately this may lead to the development of fibrosis within the corpus cavernosa and cause ED.
To prevent the onset of postoperative ED, the use of phosphodiesterase type 5 (PDE5) inhibitors was introduced. These agents prevent the breakdown of cyclic guanosine monophosphate in cavernosal tissue, which plays a role in the prevention of cell death and fibrosis, and may thus exert a protective effect on cavernosal smooth muscle.
Participants were recruited to this first robustly designed, evidence-based, multi-centre study approximately one month before they were scheduled to undergo NSRP. A total of 423 patients completed the study. The inclusion of the on-demand dosing regimen enabled comparison of the currently recommended guidelines for the use of PDE5 inhibitors with a proposed nightly dosing regimen, which was suggested to have potential positive effects on erectile function. The results clearly show that nightly dosing with vardenafil does not have any effect beyond that of on-demand use.
The study shows that on-demand use of vardenafil during the treatment period was associated with significantly greater erectile function and sexual intercourse completion rates compared to placebo. The success rates for the vardenafil on-demand group were also higher than for the nightly group. These data indicate that the use of on-demand vardenafil is of greater benefit than nightly treatment in patients following NSRP surgery and, in general, support the on-demand use of PDE5 inhibitors following NSRP surgery over a daily dosing regimen. This prompts reconsideration of the current practice of prescribing nightly PDE5 inhibitor therapy, as on-demand use of vardenafil is equally effective in men with ED following NSRP, a notoriously difficult-to-treat patient population.
Koos Admiraal | alfa
The importance of biodiversity in forests could increase due to climate change
17.11.2017 | Deutsches Zentrum für integrative Biodiversitätsforschung (iDiv) Halle-Jena-Leipzig
Win-win strategies for climate and food security
02.10.2017 | International Institute for Applied Systems Analysis (IIASA)
Heat from the friction of rocks caused by tidal forces could be the “engine” for the hydrothermal activity on Saturn's moon Enceladus. This presupposes that...
The WHO reports an estimated 429,000 malaria deaths each year. The disease mostly affects tropical and subtropical regions and in particular the African continent. The Fraunhofer Institute for Silicate Research ISC teamed up with the Fraunhofer Institute for Molecular Biology and Applied Ecology IME and the Institute of Tropical Medicine at the University of Tübingen for a new test method to detect malaria parasites in blood. The idea of the research project “NanoFRET” is to develop a highly sensitive and reliable rapid diagnostic test so that patient treatment can begin as early as possible.
Malaria is caused by parasites transmitted by mosquito bite. The most dangerous form of malaria is malaria tropica. Left untreated, it is fatal in most cases....
The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.
Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...
Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.
That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...
Computer Tomography (CT) is a standard procedure in hospitals, but so far, the technology has not been suitable for imaging extremely small objects. In PNAS, a team from the Technical University of Munich (TUM) describes a Nano-CT device that creates three-dimensional x-ray images at resolutions up to 100 nanometers. The first test application: Together with colleagues from the University of Kassel and Helmholtz-Zentrum Geesthacht the researchers analyzed the locomotory system of a velvet worm.
During a CT analysis, the object under investigation is x-rayed and a detector measures the respective amount of radiation absorbed from various angles....
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