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Long‐term potency after early use of a vacuum erection device following radical prostatectomy
Author(s) -
Raina Rupesh,
Pahlajani Geetu,
Agarwal Ashok,
Jones Stephen,
Zippe Craig
Publication year - 2010
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2010.09360.x
Subject(s) - medicine , erectile dysfunction , prostatectomy , sildenafil , prostate cancer , cgmp specific phosphodiesterase type 5 , sexual intercourse , surgery , urology , gynecology , cancer , population , environmental health
Study Type – Prognosis (case series)
Level of Evidence 4 OBJECTIVE To evaluate the long‐term potency after radical prostatectomy (RP) with the early use of a vacuum erection device (VED), and reasons for sexual inactivity and long‐term attrition and maintenance of sexual activity, as RP is one of the most common treatments for prostate cancer but erectile dysfunction (ED) is a common side‐effect. PATIENTS AND METHODS We identified 141 sexually active patients who underwent RP at Cleveland Clinic Foundation. Patients were offered various non‐oral treatment options to prevent ED and were also motivated for early penile rehabilitation. At 5 years 62% remained sexually active, of whom 71% had natural erections sufficient for intercourse without assistance, 8.5% were still using sildenafil, 10% were using combined therapy (sildenafil plus VED). At 5 years 38% (43/113) men were sexually inactive. The reasons included loss of interest in 17 (40%), cardiovascular/neurological diseases in 18 (42%), hormonal therapy in three (7%), loss of partner in three (7%) and two had other surgery. The natural rate of erections for sufficient vaginal penetration without an erection aid were preserved and maintained in the early‐prophylaxis group, and almost 60% of them had used a VED as early prophylaxis. CONCLUSION Despite current phosphodiesterase‐5 inhibitor treatments for ED, VED is becoming recognized again as having a primary role in early penile rehabilitation in many patients, specifically those treated for prostate cancer.