Use of vacuum tumescence device for impotence secondary to venous leakage

Blackard, Clyde E.; Borkon, William D.; Lima, Janet; Nelson, Joe

doi:10.1016/0090-4295(93)90561-n

Cited by 29 publications

(9 citation statements)

References 29 publications

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“…75 The compliance decreases to 50-70% after 1 year of activity. 76 Blackard et al 77 reported that VCD was effective in patients with venous leak syndrome. Twenty of 29 patients with venous leak reported satisfactory results with the VCD.…”

Section: Standard Treatment Optionsmentioning

confidence: 99%

Sexual dysfunction after pelvic surgery

et al. 2005

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Pelvic surgeries are among the most common causes of organic sexual dysfunction in men and women. The impact of nerve-sparing surgery on potency has been well documented in radical prostatectomy. However, its impact on potency needs to be evaluated in other pelvic surgeries. Sexual dysfunction is highly prevalent even after multiple technical advances in the field of oncological surgeries. The prevalence varies from 8 to 82%, depending on the type of pelvic surgery. In females, sexual dysfunction has not been evaluated adequately using validated questionnaires. However, in subspecialized circles, treatment for female sexual dysfunction is becoming routine. Currently, physicians have several options for the treatment of erectile dysfunction (ED) in men. Since the introduction of oral PDE-5 inhibitors, oral therapy has become the first-line treatment option for ED, irrespective of etiology. Currently available treatment options for the female sexual dysfunction include estrogens, androgens, phosphodiesterase inhibitors, and dopamine receptor antagonists. Initial reports regarding the role of early rehabilitation are encouraging and may become the part of routine practice in the management of ED after pelvic surgery. In this article, we summarize the sexual dysfunction following pelvic surgeries and their management. International Journal of Impotence Research (2006) IntroductionErectile dysfunction (ED) is defined as the inability to achieve and maintain an erection sufficient for satisfactory sexual intercourse. 1 Several factors have been implicated in the etiology of ED. Vascular and neurogenic causes are the most common among them. Diabetes, smoking and hypertension are the most important risk factors for vasculogenic sexual dysfunction. Neurological dysfunction is mainly associated with certain neurological syndromes like autonomic neuropathy. Sexual dysfunction after pelvic surgery has been an important and underreported cause of ED. The pathophysiology of sexual dysfunction after pelvic surgery is unique because it can be either vascular or neurogenic factors alone, or a combination of both. The pelvic surgeries in males that are associated with considerable ED include radical prostatectomy (RP), radical cystoprostatectomy (cystectomy) and low anterior or abdominoperineal resections (APRs) for rectal cancer. The pelvic surgeries in females associated with sexual dysfunction include radical cystectomy (RC) for bladder cancer, radical hysterectomy for cancers of the cervix and endometrium and, potentially, simple hysterectomy for benign tumors.In this article, we summarize male and female sexual dysfunction following pelvic surgeries for prostate, bladder and rectal cancer. We also discuss our experience in the treatment of sexual dysfunction following RP and RC. than 10%, urologists still report that the majority of patients experience ED following RRP. [3][4][5] Until recently, ED following RP was not an overwhelming concern, as most prostate cancers were detected in older men. 6 However, since the adven...

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Section: Standard Treatment Optionsmentioning

confidence: 99%

Sexual dysfunction after pelvic surgery

et al. 2005

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“…Although these three treatments (VCD, MUSE, and intracavernosal injections) have acceptable efficacy rates (33% to 68%), they also have high discontinuation rates (50% to 80%) [18,22,42]. The reasons for dissatisfaction include insufficient response to therapy, unacceptable side effects, and the feeling of anxiety and "unnaturalness" associated with using devices or injections.…”

Section: Problems With Standard Treatmentsmentioning

confidence: 93%

“…Although a published report describes efficacy rates of 60% to 80%, compliance after 1 year decreases to 50% to 70% [18] Noncompliant patients typically complain of tightness or pain from the constriction ring, diminished sensation of the phallus and glans, swiveling of the base of the penis with erection, and the laborious mechanics of using the vacuum device [19]. In addition, there is variability in the success of using the VCD each time, which leads to frustration.…”

Section: Vacuum Constriction Devicesmentioning

confidence: 95%

Management of erectile dysfunction following radical prostatectomy

et al. 2001

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Radical prostatectomy is the standard treatment for organ/specimen-confined prostate cancer, yet erectile dysfunction in selected series is still reported as high as 90% after this procedure. Thus, most men need adjuvant treatments to be sexually active following radical prostatectomy. These include vacuum constriction devices, intracorporeal injections of vasoactive drugs, and transurethral dilators, all of which have reported response rates of 50% to 70%. Unfortunately, long-term compliance is suboptimal, with a discontinuation rate of nearly 50% at one year. These non-oral options should be offered on an individual basis to patients who have failed oral therapy since efficacy and compliance vary. Also, these options should be considered in the early postoperative period to enhance sexual activity and penile oxygenation, which may prevent corporeal fibrosis. Early penile rehabilitation with intracavernosal injections or vacuum constriction devices should be encouraged to increase chances for recovery of rigid erections. In patients with some preservation of nerve tissue, oral sildenafil may be effective in promoting an earlier return of erectile function. The potential impact of sildenafil and other new oral therapies should encourage urologists to continue to perform and perfect the nerve-sparing approach.

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“…Many anecdotal reports confirm penile enhancement in patients who use vacuum therapy concurrently with penile implants (both positionable and inflatable). The vacuum device has also been recommended for patients with a veno-occlusive disorder, with 20 of 29 patients (69%) reporting success, and as enhancement to intracavernous pharmacotherapy [2,3,11].…”

Section: Eligible Patientsmentioning

confidence: 98%

External vacuum therapy for erectile dysfunction: use and results

Lewis

Witherington

1997

World J Urol

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This review assesses the continuing role of noninvasive vacuum therapy as treatment for erectile dysfunction and discusses the action of negative pressure in producing assisted erection. Through recent research in this area has centered on the development of pharmaceutical therapies, vacuum-therapy programs appear to be a consistent long-term option for patients experiencing either chronic or occasional impotence of any etiology. Very little testing is required before the initiation of vacuum treatment, and the overall; clinical success rate is approximately 90%. Significant success has been reported in more difficult patient populations, including those with veno-occlusive disorders and explanted penile prostheses. Vacuum therapy may also be used in conjunction with other therapies to enhance results. Contraindications to the use of vacuum therapy are few and primarily include patients with unexplained intermittent priapism and bleeding disorders. Side effects such as occasional numbness, pain, penile bruising, or petechiae have a low incidence. A recently reported survey of 5,847 vacuum users showed that 83.5% of patients continue to use the device for intercourse as desired. Patients should receive individual instruction in the use of these devices and should expect a learning or practice period to achieve optimal results. As newer treatments for erectile dysfunction gain increasing attention, it should be kept in mind that nearly every patient showing impotence of any degree or duration as well as patients who have failed other therapeutic choices are candidates for vacuum therapy.

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Use of vacuum tumescence device for impotence secondary to venous leakage

Cited by 29 publications

References 29 publications

Sexual dysfunction after pelvic surgery

Sexual dysfunction after pelvic surgery

Management of erectile dysfunction following radical prostatectomy

External vacuum therapy for erectile dysfunction: use and results

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