Abstract
Objectives: Erectile dysfunction (ED) and penile shortening after radical retropubic prostatectomy (RRP) are important concerns for men considering treatment alternatives for localized prostate cancer. We evaluated the impact of early utilization of the vacuum constriction device (VCD) on these outcomes.
Methods: Thirty-five patients undergoing radical retropubic prostatectomy were randomized to early (1 month post-operative, EARLY) or traditional (6 months postoperative, TRAD) use of the VCD. Preoperative International Index of Erectile Function of +/-11 (IIEF; no ED or mild ED) were required as a baseline inclusion criterion. EARLY subjects followed a daily rehabilitation protocol consisting of 10 minutes/day without the constriction ring for 5 months. Subjects were evaluated with the IIEF and measurements of the stretched penile length, a surrogate for erect penile length, preoperatively and at 1, 3, 6, 9 and 12 months.
Results: Bilateral nerve sparing was accomplished in 26 patients. IIEF scores were significantly higher in the EARLY Group than the TRAD Group at 3 months (13.99.0 vs. 2.4 +/- 1.7, p=0.002) and 6 months (12.0 +/- 8.8 vs. 2.8 +/- 2.0, p=0.029) postoperative. Fewer patients in the EARLY Group suffered from moderate to severe ED (IIEF=11) at 3 months (60% vs. 100%, p=0.002) and 6 months (50% vs. 100%, p=0.03). Significant shortening of the stretched penile length (1cm) was seen in 27% of the EARLY Group compared to 64% in the TRAD Group (p=0.06) at last follow-up.
Conclusions: Early initiation of use of the vacuum constriction device at 1-month post-radical prostatectomy improves early sexual functioning and may help preserve penile length.
Methods: Thirty-five patients undergoing radical retropubic prostatectomy were randomized to early (1 month post-operative, EARLY) or traditional (6 months postoperative, TRAD) use of the VCD. Preoperative International Index of Erectile Function of +/-11 (IIEF; no ED or mild ED) were required as a baseline inclusion criterion. EARLY subjects followed a daily rehabilitation protocol consisting of 10 minutes/day without the constriction ring for 5 months. Subjects were evaluated with the IIEF and measurements of the stretched penile length, a surrogate for erect penile length, preoperatively and at 1, 3, 6, 9 and 12 months.
Results: Bilateral nerve sparing was accomplished in 26 patients. IIEF scores were significantly higher in the EARLY Group than the TRAD Group at 3 months (13.99.0 vs. 2.4 +/- 1.7, p=0.002) and 6 months (12.0 +/- 8.8 vs. 2.8 +/- 2.0, p=0.029) postoperative. Fewer patients in the EARLY Group suffered from moderate to severe ED (IIEF=11) at 3 months (60% vs. 100%, p=0.002) and 6 months (50% vs. 100%, p=0.03). Significant shortening of the stretched penile length (1cm) was seen in 27% of the EARLY Group compared to 64% in the TRAD Group (p=0.06) at last follow-up.
Conclusions: Early initiation of use of the vacuum constriction device at 1-month post-radical prostatectomy improves early sexual functioning and may help preserve penile length.
| Original language | English (US) |
|---|---|
| Pages | 262 |
| State | Published - Nov 2006 |