Login to Access Video or Poster Abstract: MP91-18
Sources of Funding: none

Introduction

To assess the efficacy and safety of vacuum erection devices(VED) for the penile rehabilitation in patients with pelvic fracture urethral distraction defects (PFUDD) who underwent posterior urethral anastomotic urethroplasty._x000D_

Methods

This prospective study consisted of 60 patients who underwent successfully primary bulboprostatic anastomosis with a perineal approach and developed erectile dysfunction following surgery between Jan 2012 and Jun 2015. The patients were randomized to VED combined with Tadalafil (10mg) once every two days (Group 1, n=28) or Tadalafil (10mg) once every two days (Group 2, N=32) for 6 months. The International Index of Erectile Function-5(IIEF-5), nocturnal penile tumescence (NPT) testing and dynamic color-duplex Doppler ultrasonography (D-CDDU) was used as the evaluation tools. Assessments were made at 2 time points: 1 month and 7 months after urethroplasty._x000D_

Results

The mean patient age was 31.4±7.0 years (Group 1) and 33.3±7.2 years (Group 2) repectively (P>0.05). No patients ended the penile rehabilitation program because of treatment-related adverse events in both groups. In Group 1, 57.1% (16/28) patients have erections sufficient to finish the vaginal intercourse compared to 46.9% (14/32) in Group 2 at 7 months after urethroplasty. At 7 months after urethroplasty, the IIEF-5 score is (16.5±4.0) and (13.6±4.3) respectively in Group 1 and Group 2 (P<0.05). According to D-CDDU, the cavernosal artery peak systolic velocity (PSV) is (37.1±7.4) cm/second and (31.6±9.7) cm/second (P<0.05), the cavernosal artery end diastolic velocity(EDV) is (4.1±0.9) cm/second and (4.2±1.2) cm/second (P>0.05), and the penile length change is (3.1±0.9) cm and (2.4±0.9) cm(P<0.05) respectively in Group 1 and Group 2 after drug injection. NPT testing shows that the number of erectile events is (2.4±2.0) and (2.8 ±1.7) (P>0.05), the duration of erectile events is (12.1 ±4.1) min and (11.5±4.7)min (P>0.05), and the penile Avg Event Rigidity is (26.9±10.2) cm and (26.4±11.6) cm (P>0.05)respectively in Group 1 and Group 2.

Conclusions

This short term study showed that early use of VED is useful and well-tolerated in the penile rehabilitation for the patients after posterior urethral anastomotic urethroplasty because of PFUDD.

Funding

none