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External Mechanical Devices and Vascular Surgery for Erectile Dysfunction.

Published on Nov 1, 2016in The Journal of Sexual Medicine3.65
· DOI :10.1016/j.jsxm.2016.09.008
Landon Trost14
Estimated H-index: 14
(Mayo Clinic),
Ricardo Munarriz28
Estimated H-index: 28
(BU: Boston University)
+ 2 AuthorsLaurence A. Levine50
Estimated H-index: 50
(Rush University Medical Center)
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Abstract
Abstract Introduction The field of sexual medicine is continuously advancing, with novel outcomes reported on a regular basis. Given the rapid evolution, updated guidelines are essential to inform practicing clinicians on best practices. Aim To summarize the current literature and provide clinical guidelines on penile traction therapy, vacuum erection devices, and penile revascularization. Methods A consensus panel was held with leading sexual medicine experts during the 2015 International Consultation on Sexual Medicine (ICSM). Relevant literature was reviewed and graded based on Oxford criteria to develop evidence-based guideline and consensus statements. Main Outcome Measures The development of clinically relevant guidelines. Results Penile traction therapy is a viable therapy to modestly improve penile length as a primary therapy, before penile prosthesis placement in men with decreased penile length or after surgery for Peyronie's disease. It also might have a role in the acute phase of Peyronie's disease but has inconsistent outcomes in the long-term phase. Vacuum erection devices are effective in creating an erection satisfactory for intercourse, even in difficult-to-treat populations. They also might be used in the post-prostatectomy setting to maintain penile length but have insufficient evidence as a penile rehabilitation therapy. For vasculogenic erectile dysfunction, men with suspected arterial insufficiency can be evaluated with penile Duplex Doppler ultrasonography and confirmatory angiography. Penile revascularization procedures have consistently demonstrated benefits in very select patient populations; however, inadequate data exists to suggest the superiority of one technique. Men with vascular risk factors are likely poor candidates for penile revascularization, although veno-occlusive dysfunction and age are less significant. Therapies for treating primary veno-occlusive dysfunction are not recommended and should be reserved for clinical trials. Conclusions Since the prior ICSM meeting, multiple developments have occurred in external mechanical devices and penile revascularization for the treatment of erectile and sexual dysfunction. Sexual medicine clinicians are encouraged to review and incorporate recommendations as applicable to their scope of practice.
  • References (154)
  • Citations (6)
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References154
Newest
Published on Feb 1, 2016in Journal of Endovascular Therapy2.99
Regula S. von Allmen8
Estimated H-index: 8
(Kantonsspital St. Gallen),
Daniel P. Nguyen1
Estimated H-index: 1
(University of Bern)
+ 4 AuthorsNicolas Diehm27
Estimated H-index: 27
Purpose: To determine the specific lesion pattern of supplying arteries in patients with cardiovascular risk factors suffering from treatment-refractory erectile dysfunction (ED). Methods: From May 2012 to August 2013, 26 men (median age 55 years) poorly responsive to phosphodiesterase-5 inhibitor therapy were evaluated for a possible vascular cause for their ED. The men were examined with penile duplex sonography and digital subtraction angiography (DSA). Arterial lesions in the common and inte...
Published on Sep 1, 2015in Journal of Andrology3.11
Faysal A. Yafi14
Estimated H-index: 14
(Tulane University),
Russell P. Libby2
Estimated H-index: 2
(Tulane University)
+ 3 AuthorsW.J. Hellstrom8
Estimated H-index: 8
(Tulane University)
Summary Penile duplex Doppler ultrasound (PDDU) assesses the etiology of erectile dysfunction. Peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) are common PDDU parameters. We assessed whether stretched penile length (SPL) in the flaccid state and measured penile length at peak erection after intracavernosal injection (ICI) of a vasodilator during PDDU correlated with the etiology of erectile dysfunction. We performed a retrospective review of 93 patients who u...
Published on Sep 1, 2015in The Journal of Sexual Medicine3.65
Matthew J. Pagano4
Estimated H-index: 4
(CUMC: Columbia University Medical Center),
Peter J. Stahl3
Estimated H-index: 3
(CUMC: Columbia University Medical Center)
Abstract Introduction Standard operating procedures (SOP) for penile duplex Doppler ultrasound (PDDU) were published in 2013 to promote uniform vascular assessment for erectile dysfunction (ED). However, SOPs do not specify a standard anatomic location for cavernosal artery (CA) imaging. Aim The aim of this study was to determine the effects of CA imaging location on measured penile hemodynamics assessed by PDDU. Methods PDDU was performed in men with ED and/or Peyronie's disease. CA peak systol...
Published on Sep 1, 2015in The Journal of Urology5.65
Faysal A. Yafi14
Estimated H-index: 14
(Tulane University),
Michael R. Pinsky79
Estimated H-index: 79
(Tulane University)
+ 5 AuthorsWayne J.G. Hellstrom61
Estimated H-index: 61
(Tulane University)
Purpose: The concomitant use of penile traction therapy with interferon α-2b has been previously described. We present an update on our clinical experience to assess the benefit and duration of daily traction.Materials and Methods: A retrospective review of patients who underwent interferon α-2b therapy between 2001 and 2012 was performed. Charts were reviewed and data collected regarding various patient demographics, vascular parameters, objective length and curvature measurements, and use of p...
Published on May 1, 2015in The Journal of Sexual Medicine3.65
Marco Oderda12
Estimated H-index: 12
(UNITO: University of Turin),
Paolo Gontero30
Estimated H-index: 30
(UNITO: University of Turin)
Abstract Introduction Most men seeking penile enhancement techniques have a normal penile size. They are either misinformed or suffer from penile dysmorphophobia and should be discouraged from undergoing invasive procedures. Less invasive techniques including penile extenders are not associated with major complications and may be beneficial from a psychological perspective. Aim We conducted this study to assess the efficacy and safety of AndroPenis® (Andromedical, Madrid, Spain) penile extender....
Published on Mar 31, 2015in Archivio Italiano di Urologia e Andrologia
Ralf Herwig7
Estimated H-index: 7
,
Salvatore Sansalone19
Estimated H-index: 19
Objective: We evaluated the effectiveness of pelvic vein embolization with aethoxysclerol in aero-block technique for the treatment of impotence due to venous leakage in men using sildenafil for intercourse. The aim of the procedure was to reduce the use of sildenafil. Methods: A total of 96 patients with veno-occlusive dysfunction, severe enough for the need of PDE5 inhibitors for vaginal penetration, underwent pelvic venoablation with aethoxysclerol. The mean patient age was 53.5 years. Venous...
Published on Sep 1, 2014in The Journal of Sexual Medicine3.65
Ali Dabaja9
Estimated H-index: 9
(Cornell University),
Patrick Teloken9
Estimated H-index: 9
(MSK: Memorial Sloan Kettering Cancer Center),
John P. Mulhall54
Estimated H-index: 54
(MSK: Memorial Sloan Kettering Cancer Center)
Abstract Introduction Penile revascularization (PR) is a potentially curative procedure for young men with isolated arteriogenic erectile dysfunction. Standard preoperative evaluation is erectile hemodynamics (HDX) using duplex Doppler penile ultrasound (DUS) and/or cavernosometry (DIC) and assessment of cavernosal arterial anatomy by selective internal pudendal arteriography (SIPA). Aim The aim of this study was to review our experience with men who sought a second opinion from us regarding the...
Published on Sep 1, 2014in The Journal of Sexual Medicine3.65
Osama Shaeer17
Estimated H-index: 17
(Cairo University),
Kamal Shaeer10
Estimated H-index: 10
(Cairo University)
Abstract Introduction Complications of penile prosthesis implantation (PPI) are rare, nevertheless can be grave. In cases with veno‐occlusive dysfunction (VOD), alternative surgical techniques such as dorsal vein ligation (DVL) are controversial. Some patients may opt for trial at DVL to avoid the possible complications of PPI. However, this may be associated with disappointment if DVL fails and another procedure is required. Aim The aim if this study is to evaluate the results of a combined app...
Published on Jun 1, 2014in Journal of Vascular and Interventional Radiology2.83
Alberto Rebonato7
Estimated H-index: 7
(University of Perugia),
Alessio Auci2
Estimated H-index: 2
+ 5 AuthorsTito Torri6
Estimated H-index: 6
Abstract Purpose To evaluate retrospectively the safety and efficacy of anterograde embolization of the periprostatic venous plexus (AEPV) via percutaneous access of the deep dorsal vein of the penis for erectile dysfunction (ED) resulting from veno-occlusive dysfunction (VOD). Materials and Methods From September 2009 through December 2012, 18 patients with moderate to severe ED secondary to insufficiency of physiologic venous occlusion as diagnosed by color Doppler evaluation of the penis afte...
Published on May 1, 2014in Eurointervention4.02
Tzung-Dau Wang25
Estimated H-index: 25
(NTU: National Taiwan University),
Wen-Jeng Lee19
Estimated H-index: 19
+ 7 AuthorsMing-Fong Chen36
Estimated H-index: 36
AIMS: Obstructive pelvic arterial lesions are highly prevalent in patients with erectile dysfunction and commonly located in penile artery segments. In this first-in-man study, we intended to assess the safety and feasibility of balloon angioplasty for isolated penile artery stenoses in patients with erectile dysfunction. METHODS AND RESULTS: Twenty-five patients with erectile dysfunction and isolated penile artery stenoses (unilateral stenosis ≥70% or bilateral stenoses ≥50%) identified by pelv...
Cited By6
Newest
Published on Jul 1, 2019in Journal of Clinical Neuroscience1.59
Desiree Latella2
Estimated H-index: 2
,
Maria Grazia Maggio2
Estimated H-index: 2
+ 2 AuthorsRocco Salvatore Calabrò17
Estimated H-index: 17
Abstract Aim The aim of this study is to define an overview of the impact of SCI on male sexuality and provide a framework for the pathophysiology and the treatment of sexual dysfunction in male with SCI. Methods This scoping review was conducted to identificate pathophysiology and the treatment of sexual dysfunction in SCI male. Studies were identified by searching on PubMed, Web Of Science and Cochrane databases during January 2010-July 2018. Results Despite sexual dysfunction in men with SCI ...
Published on Aug 29, 2019in Medical Sciences
Eric Chung18
Estimated H-index: 18
Contemporary treatment algorithms for erectile dysfunction (ED) involve the use of medical therapies such as phosphodiesterase type 5 (PDE5) inhibitors and intracavernosal injection therapy of vasoactive agents, as well as vacuum erection devices and penile prosthesis implants in medically refractory cases. However, the current therapeutic options only address the symptoms of ED and not the underlying pathogenesis that results in ED. Newer and novel ED therapies aspire to reverse ED conditions b...
Published on Jan 1, 2019in Sexual medicine reviews
Matthew G. Cowper (Tulane University), Connor B. Burkett (Tulane University)+ 2 AuthorsWayne J.G. Hellstrom61
Estimated H-index: 61
(Tulane University)
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...
Published on Apr 1, 2019in The Journal of Sexual Medicine3.65
Eduardo P. Miranda5
Estimated H-index: 5
,
Hisanori Taniguchi4
Estimated H-index: 4
+ 3 AuthorsJohn P. Mulhall54
Estimated H-index: 54
Abstract Background Although sex aids have been used in clinical practice for ages, the scientific literature assessing their application in men with sexual dysfunction is limited. Aim To summarize medical literature regarding scientific uses of the most common sex aids in men with sexual dysfunction and assess their clinical applicability. Methods An extensive literature review was performed with regard to the use of sex aids in sexual medicine. Our search included journal articles, books, and ...
Published on Apr 1, 2019in Sexual medicine reviews
R. Avant2
Estimated H-index: 2
(Mayo Clinic),
Matthew J. Ziegelmann9
Estimated H-index: 9
(Mayo Clinic)
+ 3 AuthorsLandon Trost14
Estimated H-index: 14
(Mayo Clinic)
Abstract Introduction Peyronie's disease (PD) has historically been managed by at least 1 treatment, including oral supplements or medications, intralesional injections, or surgery. Adjunctive mechanical therapies also have been described, including penile traction therapy (PTT) and vacuum erection devices (VEDs), although relatively limited data are available on their use with PD. Aim To review and summarize the published literature on the role and efficacy of PTT and VED in men with PD. Method...
Published on Jan 1, 2019in BJUI4.52
Adam Wiggins1
Estimated H-index: 1
(Rush University Medical Center),
Peter Tsambarlis3
Estimated H-index: 3
(Rush University Medical Center)
+ 1 AuthorsLaurence A. Levine50
Estimated H-index: 50
(Rush University Medical Center)
Published on Dec 1, 2018in Urology1.86
Nora M Haney1
Estimated H-index: 1
(JHUSOM: Johns Hopkins University School of Medicine),
Taylor P. Kohn7
Estimated H-index: 7
(JHUSOM: Johns Hopkins University School of Medicine)
+ 1 AuthorsWayne J.G. Hellstrom61
Estimated H-index: 61
(Tulane University)
Objective To accurately characterize the effect of penile traction therapy (PTT) on stretched penile length (SPL) after primary treatment for men with PD. Materials and Methods A systematic search was performed for studies that evaluated the correction of PD using penile traction as secondary treatment published through January 2018. Studies were included if (1) a singular primary treatment of PD (injection or surgical treatment) was performed for all included men, (2) if there was a control gro...
Published on Apr 1, 2018in Therapeutic Advances in Urology
Daniel J. Cwikla1
Estimated H-index: 1
(UCI: University of California, Irvine),
Faysal A. Yafi14
Estimated H-index: 14
(UCI: University of California, Irvine)
The use of Clostridium histolyticum collagenase (CCH) has become increasingly widespread for the treatment of Peyronie’s disease (PD) in recent years. Numerous trials have confirmed both its safety and efficacy in appropriately selected patients with this condition. The purpose of this review is to examine pivotal trials demonstrating the efficacy of CCH, revisit viable candidates for treatment with intralesional injection therapy, and provide a summary of injection technique and appropriate man...
Published on Feb 1, 2017in The Journal of Sexual Medicine3.65
Run Wang21
Estimated H-index: 21
(University of Texas MD Anderson Cancer Center)
View next paperCurrent State of Endovascular Treatment for Vasculogenic Erectile Dysfunction