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Research Article: Assessing the impact of phosphodiesterase 5 inhibitors on survival in men after treatment for rectal cancer

Date Published: 2026-09-22

Abstract:
Phosphodiesterase type 5 inhibitors (PDE5Is) facilitate the attainment and maintenance of erections during sexual stimulation. Because erectile dysfunction is common after rectal cancer treatment, PDE5Is are frequently used in this population. We assessed whether PDE5I use was associated with overall survival after rectal cancer treatment. Methods: Utilizing data from Clalit Health Services in Israel, the analysis included 1,552 patients, with 256 users of PDE5Is. Survival differences were evaluated using categorical and non-parametric tests, Cox proportional hazards models, and propensity score matching to control for confounding variables. PDE5I use was found to be significantly associated with improved survival, with a hazard ratio of 0.455 (p<0.001). The survival benefit persisted after adjusting for covariates and implementing matching procedures. These findings suggest a potential association consistent with a protective effect of PDE5I use as well as duration of use on survival in rectal cancer patients, warranting further investigation into underlying mechanisms and clinical implications.

Introduction:
Phosphodiesterase type 5 inhibitors (PDE5Is) facilitate the attainment and maintenance of erections during sexual stimulation. Because erectile dysfunction is common after rectal cancer treatment, PDE5Is are frequently used in this population. We assessed whether PDE5I use was associated with overall survival after rectal cancer treatment. Methods: Utilizing data from Clalit Health Services in Israel, the analysis included 1,552 patients, with 256 users of PDE5Is. Survival differences were evaluated using…

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