A pilot study on the early use of the vacuum erection device after radical retropubic prostatectomy

Tobias S. Köhler, Renato Pedro, Kari Hendlin, William Utz, Roland Ugarte, Pratap Reddy, Antoine Makhlouf, Igor Ryndin, Benjamin K. Canales, Derek Weiland, Nissrine A Nakib, Anup Ramani, Kyle Anderson, Manoj Monga

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Abstract

OBJECTIVE: To evaluate the effect of the early use of the vacuum erection device (VED) on erectile dysfunction (ED) and penile shortening after radical retropubic prostatectomy (RP), as these are important concerns for men choosing among treatment alternatives for localized prostate cancer. PATIENTS AND METHODS: Twenty-eight men undergoing RP were randomized to early intervention (1 month after RP, group 1) or a control group (6 months after RP, group 2) using a traditional VED protocol. An International Index of Erectile Function (IIEF) score of >11 (no, mild or mild to moderate ED) was required as a baseline criterion for inclusion in the study. Only patients in whom unilateral or bilateral nerves were spared were subsequently randomized. Patients in group 1 followed a daily rehabilitation protocol consisting of 10 min/day using the VED with no constriction ring, for 5 months. Patients were evaluated with the IIEF-5 questionnaire and measurements of penile flaccid length, stretched length, prepubic fat pad, and midshaft circumference before and at 1, 3, 6, 9 and 12 months after RP; the mean (range) last follow-up visit was 9.5 (6-12) months after RP. RESULTS: The mean (sd) baseline IIEF scores were similar in groups 1 and 2, at 21.1 (4.6) and 22.3 (3.3), respectively (P = 0.54). The IIEF scores were significantly higher in group 1 than group 2 at 3 months, at 11.5 (9.4) vs 1.8 (1.4) (P = 0.008) and at 6 months, at 12.4 (8.7) vs 3.0 (1.9) (P = 0.012) after RP. There were no significant changes in penile flaccid length, prepubic fat pad, or mid-shaft circumference in either group. Stretched penile length was significantly decreased at both 3 and 6 months, by ≈ 2 cm (P = 0.013) in group 2. By contrast, stretched penile length was preserved in group 1 at all sample times. At the last follow-up, the proportion of men with a mean loss of penile length of ≥ 2 cm was significantly lower in group 1 than group 2 (two/17, 12%, vs five/11, P = 0.044). CONCLUSIONS: Initiating the use of a VED protocol at 1 month after RP improves early sexual function and helps to preserve penile length.

LanguageEnglish (US)
Pages858-862
Number of pages5
JournalBJU International
Volume100
Issue number4
DOIs
StatePublished - Oct 1 2007

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Prostatectomy
Vacuum
Equipment and Supplies
Erectile Dysfunction
Adipose Tissue
Constriction
Prostatic Neoplasms
Rehabilitation
Control Groups

Keywords

  • Erectile dysfunction
  • Penile length
  • Penile rehabilitation
  • Radical prostatectomy
  • Vacuum erection device

Cite this

Köhler, T. S., Pedro, R., Hendlin, K., Utz, W., Ugarte, R., Reddy, P., ... Monga, M. (2007). A pilot study on the early use of the vacuum erection device after radical retropubic prostatectomy. BJU International, 100(4), 858-862. https://doi.org/10.1111/j.1464-410X.2007.07161.x

A pilot study on the early use of the vacuum erection device after radical retropubic prostatectomy. / Köhler, Tobias S.; Pedro, Renato; Hendlin, Kari; Utz, William; Ugarte, Roland; Reddy, Pratap; Makhlouf, Antoine; Ryndin, Igor; Canales, Benjamin K.; Weiland, Derek; Nakib, Nissrine A; Ramani, Anup; Anderson, Kyle; Monga, Manoj.

In: BJU International, Vol. 100, No. 4, 01.10.2007, p. 858-862.

Research output: Contribution to journalArticle

Köhler, TS, Pedro, R, Hendlin, K, Utz, W, Ugarte, R, Reddy, P, Makhlouf, A, Ryndin, I, Canales, BK, Weiland, D, Nakib, NA, Ramani, A, Anderson, K & Monga, M 2007, 'A pilot study on the early use of the vacuum erection device after radical retropubic prostatectomy' BJU International, vol. 100, no. 4, pp. 858-862. https://doi.org/10.1111/j.1464-410X.2007.07161.x
Köhler, Tobias S. ; Pedro, Renato ; Hendlin, Kari ; Utz, William ; Ugarte, Roland ; Reddy, Pratap ; Makhlouf, Antoine ; Ryndin, Igor ; Canales, Benjamin K. ; Weiland, Derek ; Nakib, Nissrine A ; Ramani, Anup ; Anderson, Kyle ; Monga, Manoj. / A pilot study on the early use of the vacuum erection device after radical retropubic prostatectomy. In: BJU International. 2007 ; Vol. 100, No. 4. pp. 858-862.
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T1 - A pilot study on the early use of the vacuum erection device after radical retropubic prostatectomy

AU - Köhler, Tobias S.

AU - Pedro, Renato

AU - Hendlin, Kari

AU - Utz, William

AU - Ugarte, Roland

AU - Reddy, Pratap

AU - Makhlouf, Antoine

AU - Ryndin, Igor

AU - Canales, Benjamin K.

AU - Weiland, Derek

AU - Nakib, Nissrine A

AU - Ramani, Anup

AU - Anderson, Kyle

AU - Monga, Manoj

PY - 2007/10/1

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N2 - OBJECTIVE: To evaluate the effect of the early use of the vacuum erection device (VED) on erectile dysfunction (ED) and penile shortening after radical retropubic prostatectomy (RP), as these are important concerns for men choosing among treatment alternatives for localized prostate cancer. PATIENTS AND METHODS: Twenty-eight men undergoing RP were randomized to early intervention (1 month after RP, group 1) or a control group (6 months after RP, group 2) using a traditional VED protocol. An International Index of Erectile Function (IIEF) score of >11 (no, mild or mild to moderate ED) was required as a baseline criterion for inclusion in the study. Only patients in whom unilateral or bilateral nerves were spared were subsequently randomized. Patients in group 1 followed a daily rehabilitation protocol consisting of 10 min/day using the VED with no constriction ring, for 5 months. Patients were evaluated with the IIEF-5 questionnaire and measurements of penile flaccid length, stretched length, prepubic fat pad, and midshaft circumference before and at 1, 3, 6, 9 and 12 months after RP; the mean (range) last follow-up visit was 9.5 (6-12) months after RP. RESULTS: The mean (sd) baseline IIEF scores were similar in groups 1 and 2, at 21.1 (4.6) and 22.3 (3.3), respectively (P = 0.54). The IIEF scores were significantly higher in group 1 than group 2 at 3 months, at 11.5 (9.4) vs 1.8 (1.4) (P = 0.008) and at 6 months, at 12.4 (8.7) vs 3.0 (1.9) (P = 0.012) after RP. There were no significant changes in penile flaccid length, prepubic fat pad, or mid-shaft circumference in either group. Stretched penile length was significantly decreased at both 3 and 6 months, by ≈ 2 cm (P = 0.013) in group 2. By contrast, stretched penile length was preserved in group 1 at all sample times. At the last follow-up, the proportion of men with a mean loss of penile length of ≥ 2 cm was significantly lower in group 1 than group 2 (two/17, 12%, vs five/11, P = 0.044). CONCLUSIONS: Initiating the use of a VED protocol at 1 month after RP improves early sexual function and helps to preserve penile length.

AB - OBJECTIVE: To evaluate the effect of the early use of the vacuum erection device (VED) on erectile dysfunction (ED) and penile shortening after radical retropubic prostatectomy (RP), as these are important concerns for men choosing among treatment alternatives for localized prostate cancer. PATIENTS AND METHODS: Twenty-eight men undergoing RP were randomized to early intervention (1 month after RP, group 1) or a control group (6 months after RP, group 2) using a traditional VED protocol. An International Index of Erectile Function (IIEF) score of >11 (no, mild or mild to moderate ED) was required as a baseline criterion for inclusion in the study. Only patients in whom unilateral or bilateral nerves were spared were subsequently randomized. Patients in group 1 followed a daily rehabilitation protocol consisting of 10 min/day using the VED with no constriction ring, for 5 months. Patients were evaluated with the IIEF-5 questionnaire and measurements of penile flaccid length, stretched length, prepubic fat pad, and midshaft circumference before and at 1, 3, 6, 9 and 12 months after RP; the mean (range) last follow-up visit was 9.5 (6-12) months after RP. RESULTS: The mean (sd) baseline IIEF scores were similar in groups 1 and 2, at 21.1 (4.6) and 22.3 (3.3), respectively (P = 0.54). The IIEF scores were significantly higher in group 1 than group 2 at 3 months, at 11.5 (9.4) vs 1.8 (1.4) (P = 0.008) and at 6 months, at 12.4 (8.7) vs 3.0 (1.9) (P = 0.012) after RP. There were no significant changes in penile flaccid length, prepubic fat pad, or mid-shaft circumference in either group. Stretched penile length was significantly decreased at both 3 and 6 months, by ≈ 2 cm (P = 0.013) in group 2. By contrast, stretched penile length was preserved in group 1 at all sample times. At the last follow-up, the proportion of men with a mean loss of penile length of ≥ 2 cm was significantly lower in group 1 than group 2 (two/17, 12%, vs five/11, P = 0.044). CONCLUSIONS: Initiating the use of a VED protocol at 1 month after RP improves early sexual function and helps to preserve penile length.

KW - Erectile dysfunction

KW - Penile length

KW - Penile rehabilitation

KW - Radical prostatectomy

KW - Vacuum erection device

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