PDE5A and Familial prostate cancer: Contrary to these findings, using a large clinical database of patients with prostate cancer (n = 4752) with a median follow-up of 60.3 months, it was shown that the use of PDE5 inhibitors after radical prostatectomy may adversely impact biochemical recurrence (BCR), defined as a PSA of 0.2 ng/ml or greater and increasing after radical prostatectomy [226].