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Vacuum Erection Devices Revisited: Its Emerging Role in the Treatment of Erectile Dysfunction and Early Penile Rehabilitation Following Prostate Cancer Therapy

Published on Apr 1, 2012in The Journal of Sexual Medicine3.649
· DOI :10.1111/j.1743-6109.2010.01881.x
Geetu Pahlajani8
Estimated H-index: 8
(Cleveland Clinic),
Rupesh Raina26
Estimated H-index: 26
(Case Western Reserve University)
+ 2 AuthorsCraig D. Zippe48
Estimated H-index: 48
(Cleveland Clinic)
Abstract
ABSTRACT Introduction Vacuum erection devices (VEDs) are becoming first‐line therapies for the treatment of erectile dysfunction and preservation (rehabilitation) of erectile function following treatment for prostate cancer. Currently, there is limited efficacy of the use of phosphodiesterase type 5 inhibitors in elderly patients, or patients with moderate to severe diabetes, hypertension, and coronary artery disease. Aim The article aims to study the role of VED in patients following prostate cancer therapy. Results Alternative therapies such as VED have emerged as one of the primary options for patients refractory to oral therapy. VED has also been successfully used in combination treatment with oral therapy and penile injections. More recently, there has been interest in the use of VED in early intervention protocols to encourage corporeal rehabilitation and prevention of postradical prostatectomy veno‐occlusive dysfunction. This is evident by the preservation of penile length and girth that is seen with early use of the VED following radical prostatectomy. There are ongoing studies to help preserve penile length and girth with early use of VED following prostate brachytherapy and external beam radiation for prostate cancer. Recently, there has also been interest in the use of VED to help maintain penile length following surgical correction of Peyronie's disease and to increase penile size prior to implantation of the penile prosthesis. Conclusion VEDs can be one of the options for penile rehabilitation after prostate cancer therapy. Pahlajani G, Raina R, Jones S, Ali M, and Zippe C. Vacuum erection devices revisited: Its emerging role in the treatment of erectile dysfunction and early penile rehabilitation following prostate cancer therapy. J Sex Med 2012;9:1182–1189.
  • References (49)
  • Citations (33)
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References49
Newest
#1H. DerouetH-Index: 1
#2D. CaspariH-Index: 2
Last. M. ZieglerH-Index: 1
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Summary. In a retrospective study, the medical and psychological outcome of the use of external vacuum devices in the treatment of erectile dysfunction in 190 patients was evaluated, using a questionnaire and a clinical examination. 110/190 patients (57.8%) answered the questionnaire. 22/110 patients (20%) rejected the device primarily and 34/110 (30.9%) after a period of up to 16 weeks (primary rejection rate 50.9%). A secondary drop-out rate of 8/110 (7.3%) was observed after an intermediate t...
32 CitationsSource
#1Geetu Pahlajani (Cleveland Clinic)H-Index: 8
#2Rupesh Raina (Cleveland Clinic)H-Index: 26
Last. Craig D. Zippe (Cleveland Clinic)H-Index: 48
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#1Craig D. Zippe (Cleveland Clinic)H-Index: 48
#2Geetu Pahlajani (Cleveland Clinic)H-Index: 8
The increase in the number of prostate cancer survivors and their relatively young age has prompted many urologists to concentrate on early penile rehabilitation to improve potency rates following radical prostatectomy. Positive results from various procedures range from 14% to 81% following bilateral nerve-sparing laparoscopic radical prostatectomy, to 43% to 97% following robotic-assisted laparoscopic prostatectomy. An early program with an erectaid improves erectile physiology and performance...
46 CitationsSource
#1B L Dalkin (Tucson Medical Center)H-Index: 1
#2B A Christopher (Tucson Medical Center)H-Index: 1
Preservation of penile length after radical prostatectomy: early intervention with a vacuum erection device
59 CitationsSource
#1Tobias S. Köhler (UMN: University of Minnesota)H-Index: 15
#2Renato N. Pedro (UMN: University of Minnesota)H-Index: 16
Last. Manoj Monga (UMN: University of Minnesota)H-Index: 43
view all 14 authors...
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 Intern...
149 CitationsSource
#1John P. Mulhall (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 62
#2Abraham Morgentaler (Harvard University)H-Index: 40
ABSTRACT Introduction The Journal of Sexual Medicine ( JSM ) held a debate at the annual fall meeting of the Sexual Medicine Society of North America (SMSNA). The motion was “Penile Rehabilitation Should Become the Norm for Radical Prostatectomy Patients.” At the suggestion of several SMSNA members, it was requested that this debate might be of interest to JSM readers in the form of a published controversy. Methods Two debate speakers with expertise and/or strong opinions in the area of penile r...
88 CitationsSource
Introduction The Journal of Sexual Medicine (JSM) held a debate at the annual fall meeting of the Sexual Medicine Society of North America (SMSNA). The motion was “Penile Rehabilitation Should Become the Norm for Radical Prostatectomy Patients.” At the suggestion of several SMSNA members, it was requested that this debate might be of interest to JSM readers in the form of a published controversy.
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#1Nelson N. Stone (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 53
#2Richard G. Stock (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 55
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#1Manoj Monga (UMN: University of Minnesota)H-Index: 43
#2Tobias S. Köhler (UMN: University of Minnesota)H-Index: 15
Last. R. Ugarte (UMN: University of Minnesota)H-Index: 1
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#1Kalyana C. Nandipati (Cleveland Clinic)H-Index: 11
#2Rupesh Raina (Case Western Reserve University)H-Index: 26
Last. Craig D. Zippe (Cleveland Clinic)H-Index: 48
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Radical prostatectomy has been the time-honoured and standard treatment option for prostate cancer. Erectile dysfunction (ED) is one of the common quality-of-life issues following radical prostatectomy. The recovery of potency following radical prostatectomy varies from 16% to 86%. Although major modifications in surgical technique appear to be promising, the reported ED rates are still high. The time period required for the recovery of erectile function after surgery varies from 6 to 24 months....
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#2Connor B. Burkett (Tulane University)H-Index: 1
Last. Wayne J.G. Hellstrom (Tulane University)H-Index: 63
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Abstract Introduction Peyronie’s disease (PD) is a debilitating condition that affects a sizable number of men worldwide. Current treatment options consist of oral therapy, intralesional injections, and surgery. Penile stretching has been used as a treatment for PD, including penile traction therapy (PTT) and vacuum erection devices (VEDs), with numerous trials completed or underway. Aim To present and summarize the current literature on penile stretching for the treatment of PD. Methods Using P...
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Talking about pelvic surgery and prosthetic implantation means referring to a urologic oncological patient with many traumatic surgical and rehabilitative experiences. We are speaking of patients with prolonged emotional vulnerability and of partners subjected to a variety of stresses: fear of possible loss of the partner (after diagnosis) during surgical treatment, depressive fatigue and affective complicity during rehabilitation for incontinence and erectile deficiency after urologic oncologic...
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#1Feng Qin (Sichuan University)H-Index: 3
#2Shuzhen Wang (Sichuan University)H-Index: 1
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Vacuum therapy has been widely used for penile rehabilitation after radical prostatectomy (RP), but its efficacy and safety are unclear. The study was to evaluate the efficacy and safety of the early use of vacuum therapy for post-RP men. Randomized clinical trials were selected according to predefined inclusion and exclusion criteria. RevMan 5.3 software was used for meta-analyses. In total, six randomized controlled trials were included with a total of 273 post-RP patients. The meta-analysis r...
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Phosphodiesterase type 5 inhibitors (PDE5Is) are the drug of choice for medical management of erectile dysfunction (ED). On-demand PDE5Is have an overall efficacy of 60–70% for ED; 30–35% of patients fail to respond to a PDE5I, and 30–50% of non-responders can be salvaged with detailed counseling on proper use and physician follow-up to ensure that the patient has been prescribed an appropriate and full PDE5I clinical trial. True non-responders may be offered intracavernosal injections of erecto...
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