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As treatment options for erectile dysfunction (ED) continue to expand, and with more attractive alternatives such as effective systemic treatment becoming available, the number of men presenting for treatment of ED is increasing exponentially. Since a subset of these men continue to require surgical therapy, there is a potential for the number of operations for the treatment of ED and related disorders to actually increase. Areas in the surgical treatment of ED where improvements are needed are identi®ed, including: measures to prevent penile prosthesis infections, better penile implants, improved penile augmentation procedures, better surgical procedures for the treatment of Peyronie's disease, improved penile revascularization procedures, and new motor and sensory penile nerve grafting procedures.

We sought to identify factors influencing dose maintenance of intracavernous (IC) injection among patients with ED following radical prostatectomy. A total of 93 patients underwent prostatectomy and received IC treatment for ED, including PGE1 single therapy (n ¼ 53) and triple therapy (n ¼ 40). In the PGE1-only group, the maintenance dosage was significantly correlated with preoperative sexual function and nerve sparing (NS) (Po0.05). For example, the maintenance dose among patients with no, unilateral and bilateral NS was 10.8 ± 6.6 lg (0.54 ± 0.33 ml), 10.8 ± 3.8 lg (0.54 ± 0.19 ml) and 6.4 ± 4.6 lg (0.32 ± 0.23 ml), respectively. In terms of preoperative sexual function, the maintenance dose among non-ED versus ED patients was 0.38±0.25 ml (7.6±5.0 lg) and 0.59±0.31 ml (11.8±6.2 lg), respectively. No significant correlation was observed between the maintenance dose and NS or preoperative sexual function among the triple-therapy patients or between the maintenance dose and age, body mass index, systemic diseases and initiation of ED treatment among all patients (P40.05). Thus, maintenance dose of PGE1 therapy could be partly determined by NS status and prior ED of patients.

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