Erectile Recovery After Robotic-Assisted Laparoscopic Prostatectomy

NCT ID: NCT03406169

Last Updated: 2018-01-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

180 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-02-13

Study Completion Date

2022-03-31

Brief Summary

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The study is a prospective, randomized, double-blind, placebo-controlled drug study to evaluate the pattern of erectile function recovery after robotic assisted laparoscopic prostatectomy (RALP). We hope to illustrate that early and continuous therapy with either Sildenafil citrate or pentoxyfylline after nerve sparing RALP will promote improved erectile function.

Detailed Description

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Evaluation of erectile function with the International Index of Erectile Function Questionnaire (IIEF) and measurement of penile length any time between the prostate biopsy and 3 days prior to RALP will be performed.

Patients will undergo a unilateral or bilateral nerve sparing-RALP.

Patients will be randomized to receive either 25mg Viagra twice daily, 400mg pentoxifylline twice daily or placebo twice daily, starting on the first postoperative day after surgery and continuing for one year. The biostatistician generates a table of random numbers. 120 subjects anticipated to enroll at Brooke Army Medical Center will be divided into 3 groups, sildenafil, pentoxifylline or placebo. The randomization table will be given to the research pharmacist.

Patients will have their erectile function evaluated at 3 months, 6 months, 9 months, and 12 months with IIEF and sexual intercourse diary. These visits are routine for post-operative care following a RALP, however, completion of the IIEF and sexual intercourse diary are being performed for study purposes.

Patients will stop therapy at 12 months and penile length will be re-measured. Measurement of penile length will be done for study purposes at the standard 1 year post-operative follow up visit.

Patient will undergo a 6 week washout period during which neither drug will be used, then repeat analysis of erectile function with IIEF will be performed, after which they may restart standard erectile dysfunction therapy as desired. This washout period and follow up will be for study purposes.

Conditions

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Erectile Dysfunction Prostate Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Sildenafil 25mg Oral Tablet

25mg sildenafil citrate twice daily

Group Type ACTIVE_COMPARATOR

Sildenafil 25 MG Oral Tablet

Intervention Type DRUG

twice a day dosing

Pentoxifylline

400mg pentoxifylline twice daily

Group Type ACTIVE_COMPARATOR

Pentoxifylline

Intervention Type DRUG

400mg twice a day

Placebo

placebo twice daily

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

placebo twice a day

Interventions

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Sildenafil 25 MG Oral Tablet

twice a day dosing

Intervention Type DRUG

Pentoxifylline

400mg twice a day

Intervention Type DRUG

Placebo

placebo twice a day

Intervention Type OTHER

Other Intervention Names

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viagra trental

Eligibility Criteria

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Inclusion Criteria

1. Patients who have had a prostate biopsy positive for prostate cancer.
2. Patient must be age 30 - 89 years.
3. Patient must be willing to sign the Institutional Review Board approved consent.
4. Patient must have had (or be about to undergo) bilateral or unilateral nerve sparing RALP.
5. Patient must have an International IIEF equal to or greater than 21.

Exclusion Criteria

1. Patients with known unstable angina, uncontrolled hypertension, congestive heart failure, or cardiovascular accident within the preceding 2 weeks.
2. Patients being treated with nitrate therapy.
3. Patients with significant renal or hepatic impairment, cerebrovascular disease.
4. Patients with prior erectile dysfunction as indicated by the initial IIEF.
5. Patients younger than 30 years of age.
6. Patients who did/will not have a unilateral or bilateral nerve sparing radical prostatectomy.
7. Patients who have had a prior reaction to Sildenafil or pentoxifylline.
8. Patients taking any potent inhibitor of cytochrome P450 3A4 (e.g., ketoconazole, itraconazole, erythromycin, etc.).
9. Patients with a clinically significant abnormality on preoperative ECG that in the opinion of the investigator may increase the patient's cardiovascular risk in this study.
10. Patients with a history of left ventricular outflow obstruction (e.g. aortic stenosis, idiopathic hypertrophic subaortic stenosis).
11. Patients with resting hypotension (BP \< 90/50 mm Hg), or resting hypertension (BP \> 170/110 mm Hg).
12. Patients with retinitis pigmentosa.
13. Patients with a bleeding disorder.
14. Patients with active peptic ulceration.
15. Patients with conditions that may predispose to priapism (e.g. sickle cell anemia, multiple myeloma, or leukemia).
16. Patients who have previously experienced non-arteritic ischemic optic neuropathy (NAION).
Minimum Eligible Age

30 Years

Maximum Eligible Age

89 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

Yes

Sponsors

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Walter Reed National Military Medical Center

FED

Sponsor Role collaborator

Brooke Army Medical Center

FED

Sponsor Role lead

Responsible Party

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Kuwong B Mwamukonda

Staff Urologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Kuwong B Mwamukonda, MD

Role: PRINCIPAL_INVESTIGATOR

Brooke Army Medical Center

Locations

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Brooke Army Medical Center

San Antonio, Texas, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Janet Schadee, RN

Role: CONTACT

210 916-1640

Pansy Uberoi, MD

Role: CONTACT

210 916-1163

Facility Contacts

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Ileana King-Letzkus

Role: primary

210-916-2000

Other Identifiers

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C.2017.001

Identifier Type: -

Identifier Source: org_study_id

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