Experience with intracavernous injection in the treatment of erectile dysfunction after radical prostatectomy: dose considerations

Abstract

We sought to identify factors influencing dose maintenance of intracavernous (IC) injection among patients with ED following radical prostatectomy. A total of 93 patients underwent prostatectomy and received IC treatment for ED, including PGE1 single therapy (n ¼ 53) and triple therapy (n ¼ 40). In the PGE1-only group, the maintenance dosage was significantly correlated with preoperative sexual function and nerve sparing (NS) (Po0.05). For example, the maintenance dose among patients with no, unilateral and bilateral NS was 10.8 ± 6.6 lg (0.54 ± 0.33 ml), 10.8 ± 3.8 lg (0.54 ± 0.19 ml) and 6.4 ± 4.6 lg (0.32 ± 0.23 ml), respectively. In terms of preoperative sexual function, the maintenance dose among non-ED versus ED patients was 0.38±0.25 ml (7.6±5.0 lg) and 0.59±0.31 ml (11.8±6.2 lg), respectively. No significant correlation was observed between the maintenance dose and NS or preoperative sexual function among the triple-therapy patients or between the maintenance dose and age, body mass index, systemic diseases and initiation of ED treatment among all patients (P40.05). Thus, maintenance dose of PGE1 therapy could be partly determined by NS status and prior ED of patients.

Psychosocial perspectives on sexual recovery after prostate cancer treatment

“…However, further supporting evidence is needed: erections using the VED were rarely sufficient (17%) and partner s atisfaction rates were m oderate (55%). 72 ICIs early after nerve-sparing prostatectomy might increase the recovery rate of spontaneous erections, 43,74,75 although further studies are needed to confirm this effect. Patients who start using ICIs earlier (<3 months) after radical prostatectomy report firmer erections and better compliance compared with those who wait.…”

“…122 Multiple ICI agents can be combined to increase their effectiveness. 75 It should be noted that the additive effect of combining two or more erectogenic medicinal agents is usually reserved for severe ED. Physicians who are not familiar with this treatment protocol should refer to a urologist or sexual medicine expert to decrease the risk of p riapism for the patient.…”