Parsons J K et al. (2004) Effect of methylprednisolone on return of sexual function after nerve-sparing radical retropubic prostatectomy. Urology 64: 987–990

Erectile dysfunction is a common complication of radical retropubic prostatectomy (RRP), despite the development of nerve-sparing operative techniques. Having observed that sexual function tends to be restored more quickly in patients who are receiving steroids after this procedure, Parsons and colleagues hypothesized that surgical inflammation might contribute to the loss of potency. They have recently carried out a randomized study to assess whether postoperative methylprednisolone might speed the recovery of sexual function in such patients.

The study included 70 men undergoing bilateral nerve-sparing RRP by the same surgeon. Patients received a tapered regimen of methylprednisolone (n = 34) or placebo (n = 36) for six days, beginning on postoperative day one. The methylprednisolone dosage was designed to produce a systemic anti-inflammatory effect without causing problems with wound healing. The potency of the participants was measured at 3, 6 and 12 months postoperatively using the International Index of Erectile Function (IIEF)-5 questionnaire.

The authors observed no significant differences between the placebo and active treatment groups in the proportion of men who were potent at each time point. Twelve months after surgery, potency was reported by 74% of patients in the methylprednisolone group and 71% of those who received placebo (P = 0.8). Methylprednisolone appeared to have no detrimental effects on wound healing or postoperative urinary continence.

Concluding that methylprednisolone did not improve the recovery of sexual function in this study, the authors note that a positive response might have been achieved using higher doses or earlier administration of the drug.