Intracavernous injection in the treatment of erectile dysfunction after radical prostatectomy: an observational study

Claro, Joaquim de Almeida; Aboim, José Elêrton de; Maríngolo, Marcelo; Andrade, Enrico; Aguiar, Wilson; Nogueira, Marcos de Paula; Júnior, Archimedes Nardozza; Srougi, Miguel

doi:10.1590/s1516-31802001000400004

Cited by 27 publications

(12 citation statements)

References 5 publications

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“…Long-term treatment (3 years after RP) produced an overall response rate of up to 71% spontaneous erections with on pharmacological support [16]. The success rate achieved using ICI therapy with vasoactive agents (prostaglandin-1) reached 90% in the first 6 months after RP (provided EF was fully intact before RP) [17].…”

Section: Discussionmentioning

confidence: 99%

Recovery of erectile function after nerve‐sparing radical prostatectomy: improvement with nightly low‐dose sildenafil

et al. 2008

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OBJECTIVE To evaluate the effect of low‐dose sildenafil for rehabilitating erectile function after nerve‐sparing radical prostatectomy (NSRP), as the delay to recovery of erectile function after NSRP remains under debate. PATIENTS AND METHODS Forty‐three sexually active patients had a NSRP; at 7–14 days after surgery they had a Rigiscan® (Dacomed Corporation, Minneapolis, MN, USA) measurement of nocturnal penile tumescence and rigidity (NPTR). To support the recovery of spontaneous erectile function, 23 patients with preserved nocturnal erections received sildenafil 25 mg/day at night. A control group of 18 patients were then followed but had no phosphodiesterase‐5 inhibitors. The International Index of Erectile Function (IIEF)‐5 questionnaire was completed 6, 12, 24, 36 and 52 weeks after NSRP. RESULTS Of the 43 patients, 41 (95%) had one to five erections during the first night after catheter removal. In the group using daily sildenafil the mean IIEF‐5 score decreased from 20.8 before NSRP to 3.6, 3.8, 5.9, 9.6 and 14.1 at 6, 12, 24, 36 and 52 weeks after NSRP, respectively. In the control group the respective scores were 21.2, decreasing to 2.4, 3.8, 5.3, 6.4 and 9.3. There was a significant difference in IIEF‐5 score and time to recovery of erectile function between the groups (P < 0.001), with potency rates of 86% vs 66%. CONCLUSION The measurement of NPTR after NSRP showed erectile function even the ‘first’ night after catheter removal. In cases of early penile erection, daily low‐dose sildenafil leads to a significant improvement in the recovery of erectile function.

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Section: Discussionmentioning

confidence: 99%

Recovery of erectile function after nerve‐sparing radical prostatectomy: improvement with nightly low‐dose sildenafil

et al. 2008

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“…94.6% of the 168 patients in the study were able to achieve a successful erection with ICI of trimix in the home setting, and 40% of these patients had previously failed oral PDE5 inhibitor therapy. 13.1% of the patients eventually recovered full erections after treatment periods ranging from 5 to 18 months [87]. In another retrospective study conducted at a single center, Domes et al.…”

Section: Ici Therapy For Penile Rehabilitation After Rpmentioning

confidence: 92%

Intracavernosal Injection for the Diagnosis, Evaluation, and Treatment of Erectile Dysfunction: A Review

Belew

Klaassen

Lewis

2015

Sexual Medicine Reviews

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“…Claro et al30 reported that when intracavernosal injection was conducted on patients who had normal sexual function before curative surgery, but who had postoperative erectile dysfunction, 40% of the patients showed a good result, and 94.6% showed erection sufficient to have sexual intercourse. In a long-term follow-up study conducted by Raina et al,31 one-third of patients who complained of erectile dysfunction after curative surgery selected intracavernosal injection as a primary treatment method; of them, 48% received a mean 3.7-year long-term treatment.…”

Section: Treatment Of Sexual Dysfunction Following the Treatment Of Pmentioning

confidence: 99%

Prostate Cancer and Sexual Function

Hyun

2012

World J Mens Health

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Prostate cancer is now ranked fifth in incidence among cancers in Korean adult males. This is attributable to the more Westernized dietary style which increases the morbidity of prostate cancer and the development of cancer diagnostic technologies, such as prostate-specific antigen and advanced medical systems, increasing the rate of prostate cancer diagnosis. Prostate cancer effects include not only erectile dysfunction caused by the disease itself, but also by psychiatric disorders caused by prostate cancer or its treatments. Prostate cancer by itself reduces sexual desire and the frequency of sexual intercourse. Additionally, surgery or hormonal therapy to block testosterone further increases the frequency of erectile dysfunction. Erectile dysfunction following radical prostatectomy is primarily attributable to nerve injury caused by intraoperative nerve traction, thermal injury, ischemic injury, and local inflammatory reactions. Additionally, the absence of nocturnal penile tumescence causes persistent hypoxia of the corpus cavernosum, which, secondarily, causes anatomical and functional changes in the corpus cavernosum. Preservation of erectile function is one of the most significant issues for patients with local prostate cancer. Erectile dysfunction following radical prostatectomy is known to have various prognoses, depending on preservation of the neurovascular bundle, patient age, and preoperative erectile status. Intracavernosal injections, PDE5 inhibitors, and penile rehabilitation therapy using a vacuum constriction device after radical prostatectomy are known to improve the recovery of erectile function. Recently, testosterone replacement therapy has also drawn attention as a treatment method.

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Intracavernous injection in the treatment of erectile dysfunction after radical prostatectomy: an observational study

Abstract: Self-injection therapy with papaverine, phentolamine and prostaglandin E1 is effective and safe in the treatment of erectile dysfunction after radical prostatectomy.

Cited by 27 publications

References 5 publications

Recovery of erectile function after nerve‐sparing radical prostatectomy: improvement with nightly low‐dose sildenafil

Recovery of erectile function after nerve‐sparing radical prostatectomy: improvement with nightly low‐dose sildenafil

Intracavernosal Injection for the Diagnosis, Evaluation, and Treatment of Erectile Dysfunction: A Review

Prostate Cancer and Sexual Function

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