Effect on sexual function of a vacuum erection device post-prostatectomy.

INTRODUCTION

Treatment of erectile dysfunction (ED) subsequent to bilateral nerve sparing robotic prostatectomy (BNSRP) with tadalafil plus a vacuum erection device (VED) may improve return of sexual function.

MATERIALS AND METHODS

Men with prostate cancer who had BNSRP were randomized to receive tadalafil, 20 mg three times weekly, or tadalafil plus a VED, 10 minutes unbanded per day for at least 5 days weekly. Treatments started 1 month after surgery; clinic visits were at 1, 3, 6, 9 and 12 months. Patients were requested to attempt intercourse at least twice before each visit. At every visit patients completed the International Index of Erectile Function (IIEF-5) questionnaire and a penile hardness scale (1-4) and were questioned as to their ability to have vaginal penetration and intercourse to orgasm.

RESULTS

Thirteen men started the combination regimen, and there were no dropouts; 10 patients started the tadalafil treatment, and three men dropped out. The mean IIEF-5 at months 6, 9 and 12 were significantly higher for the combination group, while the penile hardness scores were significantly greater for the combination group at 6 and 9 months. After 12 months 92% of combination patients responded yes to the vaginal penetration question versus 57% of the tadalafil group; corresponding figures were 92% and 29%, respectively, for intercourse to orgasm. Compliance to the VED was superior to that of tadalafil.

CONCLUSION

Men with ED subsequent to BNSRP had a more rapid and complete return of sexual function when treated with tadalafil plus VED versus tadalafil alone.