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Penile Rehabilitation after Prostate Cancer Treatment: Which Is the Right Program? URO 2023. [DOI: 10.3390/uro3010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
The management of sexual complications after treatment of localized prostate cancer, such as erectile dysfunction, changes in the length of the penis, pain during sexual intercourse, and lack of orgasm, is still an unsolved problem with an important impact on patients’ quality of life. In this review, we summarize the current scientific literature about the rehabilitation of erectile dysfunction after prostate cancer treatment. The therapy for penile rehabilitation includes different types of treatments: the combination of phosphodiesterase type 5 inhibitors (PDE5-I) and the vacuum erectile device (VED) are considered first-line treatment options. When therapy begins, the duration of treatment, the dosage and the drug used all play very important roles in the treatment outcome. Intracavernous injection (ICI) therapy represents the second-line option for patients ineligible for PDE5-I therapy. Technological development has led to the emergence of devices for the stimulation of the penis without the use of drugs, such as penile vibratory stimulation (PVS) for stimulation of ejaculation in spinal cord injury and low-intensity extracorporeal shockwave therapy (LIESWT). The rapid diffusion of the latter, thanks to its easy use, attains good results without side effects. The panorama of penile rehabilitation after PC treatments is vast and many studies are needed, especially on new technologies, to find the best therapeutic regimen possible, personalized to the patient’s characteristics and the type of treatment for PC.
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Domes T, Najafabadi BT, Roberts M, Campbell J, Flannigan R, Bach P, Patel P, Langille G, Krakowsky Y, Violette PD, Brock GB, Yafi FA. Canadian Urological Association guideline: Erectile dysfunction. Can Urol Assoc J 2021; 15:310-322. [PMID: 34665713 DOI: 10.5489/cuaj.7572] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Erectile dysfunction (ED) impacts the wellness and quality of life of millions of Canadians. An evaluation focused on the identification of reversible and irreversible underlying factors is recommended for patients presenting with ED. Through a shared decision-making model framework, the goal of ED treatment is to improve functional outcomes and enhance sexual satisfaction while minimizing adverse effects associated with treatment. Given that ED is assessed and treated by multiple different types of health practitioners, the purpose of this guideline is to provide the best available evidence to facilitate care delivery through a Canadian lens. After a narrative review of ED assessment and treatment for general readership, five key clinical questions relating to priority areas of ED are assessed using the GRADE and evidence-to-decision-making frameworks.
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Affiliation(s)
- Trustin Domes
- Division of Urology, Department of Surgery, University of Saskatchewan, Saskatoon, SK, Canada
| | - Borna Tadayon Najafabadi
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Matthew Roberts
- Division of Urology, Department of Surgery, University of Ottawa, Ottawa, ON, Canada
| | - Jeffrey Campbell
- Division of Urology, Department of Surgery, Western University, London, ON, Canada
| | - Ryan Flannigan
- Department of Urological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Phil Bach
- Division of Urology, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Premal Patel
- Division of Urology, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada
| | | | - Yonah Krakowsky
- Division of Urology, Women's College Hospital & Sinai Health System, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Philippe D Violette
- Department of Surgery, McMaster University, Hamilton, ON, Canada.,Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Gerald B Brock
- Professor Emeritus, Western University, London, ON, Canada
| | - Faysal A Yafi
- Department of Urology, University of California Irvine, Irvine, CA, United States
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Le TV, Tsambarlis P, Hellstrom WJG. Pharmacodynamics of the agents used for the treatment of erectile dysfunction. Expert Opin Drug Metab Toxicol 2018; 15:121-131. [DOI: 10.1080/17425255.2019.1560421] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Tan V. Le
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Vietnam
| | - Peter Tsambarlis
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
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Emanu JC, Avildsen IK, Nelson CJ. Erectile dysfunction after radical prostatectomy: prevalence, medical treatments, and psychosocial interventions. Curr Opin Support Palliat Care 2016; 10:102-7. [PMID: 26808052 DOI: 10.1097/spc.0000000000000195] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW This review will discuss erectile dysfunction in prostate cancer patients following radical prostatectomy . It will focus on the prevalence and current treatments for erectile dysfunction as well as the emotional impact of erectile dysfunction and the current psychosocial interventions designed to help patients cope with this side effect. RECENT FINDINGS Although there is a large discrepancy in prevalence rates of erectile dysfunction after radical prostatectomy, several recent studies have cited rates as high as 85%. The concept of 'penile rehabilitation' is now the standard of practice to treat erectile dysfunction following radical prostatectomy. However, many men avoid seeking help or utilizing erectile dysfunction treatments. This avoidance is related to the shame, frustration, and distress many men with erectile dysfunction and their partners experience. Recent psychosocial interventions have been developed to facilitate the use of treatments and help men cope with erectile dysfunction. These interventions have shown initial promise, however, continued intervention development is needed to reduce distress and improve long-term erectile function outcomes. SUMMARY Erectile dysfunction is a significant problem following prostate cancer surgery. Although there are effective medical treatments, the development of psychosocial interventions should continue to evolve to maximize the assistance we can give to men and their partners.
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Affiliation(s)
- Jessica C Emanu
- Department of Psychiatry and Behavioral Sciences Memorial Sloan Kettering Cancer Center, New York, USA
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El-Sakka AI. What is the current role of intracavernosal injection in management of erectile dysfunction? Int J Impot Res 2016; 28:88-95. [DOI: 10.1038/ijir.2016.14] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 11/14/2015] [Accepted: 03/14/2016] [Indexed: 12/15/2022]
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Salonia A, Castagna G, Capogrosso P, Castiglione F, Briganti A, Montorsi F. Prevention and management of post prostatectomy erectile dysfunction. Transl Androl Urol 2016; 4:421-37. [PMID: 26816841 PMCID: PMC4708594 DOI: 10.3978/j.issn.2223-4683.2013.09.10] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Sexual dysfunction is common in patients with prostate cancer (PC) following radical prostatectomy (RP). Review the available literature concerning prevention and management strategies for post-RP erectile function (EF) impairment in terms of preoperative patient characteristics, intra and postoperative factors that may influence EF recovery, and postoperative treatments for erectile dysfunction (ED). A literature search was performed using Google and PubMed database for English-language original and review articles, either published or e-published up to July 2013. The literature still demonstrates a great inconsistency in the definition of what is considered normal EF both before and after RP. Thus, using validated psychometric instruments with recognized cut-offs for normalcy and severity during the pre- and post-operative evaluation should be routinely considered. Therefore, a comprehensive discussion with the patient about the true prevalence of postoperative ED, the concept of spontaneous or pharmacologically-assisted erections, and the difference between “back to baseline” EF and “erections adequate enough to have successful intercourse” clearly emerge as key issues in the eventual understanding of post-RP ED prevention and promotion of satisfactory EF recovery. Patient factors (including age, baseline EF, comorbid conditions status), cancer selection (non- vs. uni- vs. bilateral nerve-sparing), type of surgery (i.e., intra vs. inter vs. extrafascial surgeries), surgical techniques (i.e., open, laparoscopic and robotically-assisted RP), and surgeon factors (i.e., surgical volume and surgical skill) represent the key significant contributors to EF recovery. A number of preclinical and clinical data show that rehabilitation and treatment in due time are undoubtedly better than leaving the erectile tissue to its unassisted postoperative fate. The role of postoperative ED treatment for those patients who received a non-nerve-sparing RP was also extensively discussed. Optimal outcomes are achieved mainly by the careful choice of the correct patient for the correct type of surgery. Despite a plethora of potential rehabilitative approaches, they should be only considered as “strategies”, since incontrovertible evidence of their effectiveness for improving natural EF recovery is limited. Conversely, numerous effective therapeutic options are available for treating post-RP ED.
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Affiliation(s)
- Andrea Salonia
- 1 Department of Urology, University Vita-Salute San Raffaele, Milan, Italy ; 2 Research Doctorate Program in Urology, Magna Graecia University, Catanzaro, Italy
| | - Giulia Castagna
- 1 Department of Urology, University Vita-Salute San Raffaele, Milan, Italy ; 2 Research Doctorate Program in Urology, Magna Graecia University, Catanzaro, Italy
| | - Paolo Capogrosso
- 1 Department of Urology, University Vita-Salute San Raffaele, Milan, Italy ; 2 Research Doctorate Program in Urology, Magna Graecia University, Catanzaro, Italy
| | - Fabio Castiglione
- 1 Department of Urology, University Vita-Salute San Raffaele, Milan, Italy ; 2 Research Doctorate Program in Urology, Magna Graecia University, Catanzaro, Italy
| | - Alberto Briganti
- 1 Department of Urology, University Vita-Salute San Raffaele, Milan, Italy ; 2 Research Doctorate Program in Urology, Magna Graecia University, Catanzaro, Italy
| | - Francesco Montorsi
- 1 Department of Urology, University Vita-Salute San Raffaele, Milan, Italy ; 2 Research Doctorate Program in Urology, Magna Graecia University, Catanzaro, Italy
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Martínez-Salamanca JI, Zurita M, Costa C, Martínez-Salamanca E, Fernández A, Castela A, Vaquero J, Carballido J, Angulo J. Dual Strategy With Oral Phosphodiesterase Type 5 Inhibition and Intracavernosal Implantation of Mesenchymal Stem Cells Is Superior to Individual Approaches in the Recovery of Erectile and Cavernosal Functions After Cavernous Nerve Injury in Rats. J Sex Med 2016; 13:1-11. [DOI: 10.1016/j.jsxm.2015.12.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Accepted: 11/30/2015] [Indexed: 01/21/2023]
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Yiou R, Bütow Z, Parisot J, Binhas M, Lingombet O, Augustin D, de la Taille A, Audureau E. Is it worth continuing sexual rehabilitation after radical prostatectomy with intracavernous injection of alprostadil for more than 1 year? Sex Med 2015; 3:42-8. [PMID: 25844174 PMCID: PMC4380913 DOI: 10.1002/sm2.51] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction Intracavernous alprostadil injection (IAI) is a widely used treatment for sexual rehabilitation (SR) after radical prostatectomy (RP). It is unknown whether the continuation of IAI beyond 1 year continues to improve erectile function. Aims To assess evolution of sexual function in patients using IAI who are nonresponsive to phosphodiesterase type 5 inhibitors (PDE5i) between 12 (M12) and 24 (M24) months after RP. Methods We retrospectively studied 75 men with a nerve-sparing laparoscopic RP, who had normal preoperative erectile function, and who regularly used IAI for SR for at least 24 months. At M12, no patients had responded to PDE5i. Main Outcome Measures At 12 and 24 months, sexual function was assessed with the UCLA Prostate Cancer Index (UCLA-PCI), International Index of Erectile Function (IIEF)-15, and erection hardness score (EHS) with and without IAI. We also assessed the satisfaction rate with IAI, injection-related penile pain, and satisfaction of treatment. Statistical analysis was performed by using t-tests for paired data and Spearman's rho correlation coefficients to assess the relationships between scores at M12 and M24. Results Improvement of nocturnal erection was noted (UCLA-PCI, question 25); however, no significant difference was found for IIEF-erectile function with (19.60 ± 9.80 vs. 18.07 ± 10.44) and without IAI (4.63 ± 2.93 vs. 4.92 ± 4.15), UCLA-PCI-sexual bother (37.14 ± 21.45 vs. 37.54 ± 19.67), nor the EHS score with (2.97 ± 1.30 vs. 2.57 ± 1.30) and without IAI (0.67 ± 1.11 vs. 0.76 ± 0.10). The rate of satisfaction with treatment decreased over time (66.6% vs. 46.7%, P = 0.013). Improved response to IAI at M12 was not correlated to improvement in spontaneous erections at M24. Conclusion The response to IAI remained stable after 2 years of treatment, and no significant improvement of spontaneous erections during intercourse attempts was found between M12 and M24. Patients should be informed of the limited effect of IAI on natural erections after 1 year. Yiou R, Bütow Z, Parisot J, Binhas M, Lingombet O, Augustin D, de la Taille A, and Audureau E. Is it worth continuing sexual rehabilitation after radical prostatectomy with intracavernous injection of alprostadil for more than 1 year? Sex Med 2015;3:42–48.
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Affiliation(s)
- René Yiou
- Department of Urology, Henri Mondor Teaching Hospital Créteil, France
| | - Zentia Bütow
- Department of Urology, Henri Mondor Teaching Hospital Créteil, France
| | - Juliette Parisot
- Department of Public Health, LIC EA4393, Université Paris Est (UPEC), Henri Mondor Teaching Hospital Créteil, France
| | - Michele Binhas
- Department of Anesthesiology, Henri Mondor Teaching Hospital Créteil, France
| | - Odile Lingombet
- Department of Urology, Henri Mondor Teaching Hospital Créteil, France
| | - Deborah Augustin
- Department of Urology, Henri Mondor Teaching Hospital Créteil, France
| | | | - Etienne Audureau
- Department of Public Health, LIC EA4393, Université Paris Est (UPEC), Henri Mondor Teaching Hospital Créteil, France
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Belew D, Klaassen Z, Lewis RW. Intracavernosal Injection for the Diagnosis, Evaluation, and Treatment of Erectile Dysfunction: A Review. Sex Med Rev 2015; 3:11-23. [DOI: 10.1002/smrj.35] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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10
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Martínez‐Salamanca JI, La Fuente JM, Fernández A, Martínez‐Salamanca E, Pepe‐Cardoso AJ, Carballido J, Angulo J. Nitrergic Function Is Lost but Endothelial Function Is Preserved in the Corpus Cavernosum and Penile Resistance Arteries of Men after Radical Prostatectomy. J Sex Med 2015; 12:590-9. [DOI: 10.1111/jsm.12801] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jiang P, Christakos A, Fam M, Sadeghi-Nejad H. Prophylactic phenylephrine for iatrogenic priapism: a pilot study with Peyronie's patients. Korean J Urol 2014; 55:665-9. [PMID: 25324950 PMCID: PMC4198766 DOI: 10.4111/kju.2014.55.10.665] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 08/20/2014] [Indexed: 12/03/2022] Open
Abstract
Purpose Although penile duplex Doppler ultrasonography (PDDU) is a common and integral procedure in a Peyronie's disease workup, the intracavernosal injection of vasoactive agents can carry a serious risk of priapism. Risk factors include young age, good baseline erectile function, and no coronary artery disease. In addition, patients with Peyronie's disease undergoing PDDU in an outpatient setting are at increased risk given the inability to predict optimal dosing. The present study was conducted to provide support for a standard protocol of early administration of phenylephrine in patients with a sustained erection after diagnostic intracavernosal injection of vasoactive agents to prevent the deleterious effects of iatrogenic priapism. Materials and Methods This was a retrospective review of Peyronie's disease patients who received phenylephrine reversal after intracavernosal alprostadil (prostaglandin E1) administration to look at the priapism rate. Safety was determined on the basis of adverse events reported by subjects and efficacy was determined on the basis of the rate of priapism following intervention. Results Patients with Peyronie's disease only had better hemodynamic values on PDDU than did patients with Peyronie's disease and erectile dysfunction. All of the patients receiving prophylactic phenylephrine had complete detumescence of erections without adverse events, including no priapism cases. Conclusions The reversal of erections with phenylephrine after intracavernosal injections of alprostadil to prevent iatrogenic priapism can be effective without increased adverse effects.
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Affiliation(s)
- Pengbo Jiang
- Department of Urology, Rutgers-New Jersey Medical School, Newark, NJ, USA
| | - Athena Christakos
- Department of Urology, Rutgers-New Jersey Medical School, Newark, NJ, USA
| | - Mina Fam
- Department of Urology, Rutgers-New Jersey Medical School, Newark, NJ, USA
| | - Hossein Sadeghi-Nejad
- Department of Urology, Rutgers-New Jersey Medical School, Newark, NJ, USA. ; Center for Male Reproductive Medicine & Microsurgery, Hackensack University Medical Center, Hackensack, NJ, USA
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Hamilton Z, Mirza M. Post-prostatectomy erectile dysfunction: contemporary approaches from a US perspective. Res Rep Urol 2014; 6:35-41. [PMID: 24892031 PMCID: PMC4029758 DOI: 10.2147/rru.s39560] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Success of cancer surgery often leads to life-changing side effects, and surgical treatment for malignant urologic disease often results in erectile dysfunction (ED). Patients that undergo surgical prostatectomy or cystoprostatectomy will often experience impairment of erections due to disruption of blood and nerve supply. Surgical technique, nerve sparing status, patient age, comorbid conditions, and pretreatment potency status all have an effect on post-surgical ED. Regardless of surgical technique, prostatectomy results in disruption of normal anatomy and nerve supply to the penis, which governs the functional aspects of erection. A variety of different treatment options are available for men who develop ED after prostatectomy, including vacuum erection device, oral phosphodiesterase 5 inhibitors (PDE5I), intracorporal injections, and penile prosthesis. The vacuum erection device creates an artificial erection by forming a vacuum via suction of air to draw blood into the penis. The majority of men using the vacuum erection device daily after prostatectomy, regardless of nerve-sparing status, have erections sufficient for intercourse. Phosphodiesterase 5 inhibitors remain a common treatment option for post-surgical ED and are the mainstay of therapy. They work through cyclic adenosine monophosphate and cyclic guanine monophosphate pathways and are recommended in all forms of ED. Intracorporal injections or intraurethral use of vasoactive substances may be a good second-line therapy in men who do not experience improvement with oral medications. Surgical placement of a penile prosthesis is typically the treatment strategy of choice after other options have failed. Semi-rigid and inflatable devices are available with high satisfaction rates. With careful patient counseling and proper treatment selection, patient satisfaction and improved erectile function can be achieved. We advise that patients use a vacuum erection device daily in the early postoperative period in combination with an oral PDE5I. For patients who do not respond to a vacuum erection device or PDE5I, consideration should be given to intraurethral alprostadil, intracorporal injections, or a penile prosthesis.
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Affiliation(s)
- Zachary Hamilton
- Department of Urology, University of Kansas, Kansas City, KS, USA
| | - Moben Mirza
- Division of Urologic Oncology, Department of Urology, University of Kansas, Kansas City, KS, USA
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Sung HH, Ahn JS, Kim JJ, Choo SH, Han DH, Lee SW. The role of intracavernosal injection therapy and the reasons of withdrawal from therapy in patients with erectile dysfunction in the era of PDE5 inhibitors. Andrology 2013; 2:45-50. [DOI: 10.1111/j.2047-2927.2013.00155.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 09/24/2013] [Accepted: 10/08/2013] [Indexed: 12/26/2022]
Affiliation(s)
- H. H. Sung
- Department of Urology; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| | - J. S. Ahn
- Department of Urology; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| | - J. J. Kim
- Department of Urology; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| | - S. H. Choo
- Department of Urology; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| | - D. H. Han
- Department of Urology; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| | - S. W. Lee
- Department of Urology; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
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Prabhu V, Alukal JP, Laze J, Makarov DV, Lepor H. Long-term satisfaction and predictors of use of intracorporeal injections for post-prostatectomy erectile dysfunction. J Urol 2012; 189:238-42. [PMID: 23174252 DOI: 10.1016/j.juro.2012.08.089] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Indexed: 01/22/2023]
Abstract
PURPOSE Intracorporeal injections have low use rates and high discontinuation rates. We examined factors associated with intracorporeal injection use, long-term satisfaction with intracorporeal injection and reasons for discontinuation in men treated with radical prostatectomy. MATERIALS AND METHODS Between October 2000 and September 2003, 731 men who underwent open radical retropubic prostatectomy were enrolled in a prospective outcomes study. The 8-year followup evaluation included the UCLA-PCI, and a survey capturing intracorporeal injection use, satisfaction and reasons for discontinuation. Logistic regression was used to determine associations between intracorporeal injection use and preoperative variables. RESULTS The 8-year self-assessment was completed by 368 (50.4%) men. Of these men 140 (38%) indicated prior or current intracorporeal injection use, with only 34 using intracorporeal injection at 8 years. Overall, 44% of the men were satisfied with intracorporeal injections. Reasons for discontinuation included dislike (47%), pain (33%), return of erection (19%), inefficacy (14%) and no partner (6%). Men trying intracorporeal injections had greater preoperative UCLA-PCI sexual function scores (75.2 vs 65.62, p = 0.00005) as well as greater decreases in this score at 3 months (p = 0.0002) and 2 years (p = 0.003). Higher preoperative sexual function scores were independently associated with the use of intracorporeal injections in a model adjusted for age, marital status, nerve sparing status and body mass index (OR 1.021, 95% CI 1.008-1.035). CONCLUSIONS Men pursuing intracorporeal injections have better baseline erectile function and experience greater deterioration in erectile function during the early postoperative period. Despite the high efficacy of injections, many men discontinue intracorporeal injections due to dislike or discomfort. Satisfaction rates for intracorporeal injections indicate their long-term role in restoring sexual function in men with post-prostatectomy erectile dysfunction.
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Affiliation(s)
- Vinay Prabhu
- Department of Urology, New York University School of Medicine, New York, New York 10016, USA
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