A Double-Blind, Randomized Trial on the Efficacy and Safety of Hyperbaric Oxygenation Therapy in the Preservation of Erectile Function after Radical Prostatectomy

Chiles, Kelly A.; Staff, Ilene; Johnson‐Arbor, Kelly; Champagne, Alison; McLaughlin, Tara; Graydon, R. James

doi:10.1016/j.juro.2017.10.016

Cited by 29 publications

(26 citation statements)

References 14 publications

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“…This suggests that HBOT can be beneficial even when ED is not due to tissue damage. However, it should be noted that a recent study by Chiles et al [25] did not find any improvement in IIEF scores after HBOT in prostate cancer patients treated with nerve-sparing robotic radical prostatectomy. They randomized the patients as sildenafil 50 mg daily + HBOT and control group (sildenafil 50 mg daily + normal air) after nerve-sparing robotic radical prostatectomy.…”

Section: Discussionmentioning

confidence: 80%

The Effect of Hyperbaric Oxygen Therapy on Erectile Functions: A Prospective Clinical Study

et al. 2018

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Introduction: We aimed to evaluate the effects of hyperbaric oxygen therapy (HBOT) on erectile function in patients who had no cavernosal or urethral injury by using International Index of Erectile Function (IIEF) questionnaire. Materials and Methods: The male patients who were treated by HBOT for several diseases between July 2017 and September 2017 were examined. All patients filled the IIEF questionnaire form before the first day and after the last day of HBOT and a questionnaire including demographic characteristics and medical history. The effects of demographic characteristics and risk factors on erectile function were evaluated, and the IIEF domain scores of patients in first day and last day of HBOT were compared. Results: Totally, 50 patients were included in the study between July 2017 and September 2017 and the mean age was 59.38 ± 13.77. The mean post-HBOT IIEF-EF score of patients was significantly higher than the mean pre-HBOT IIEF-EF score of patients (15.74 ± 10.52 vs. 19.50 ± 10.91; p < 0.001). The mean post-HBOT IIEF scores of other domains including intercourse satisfaction, orgasmic function, sexual desire, and overall satisfaction were also significantly higher than pre-HBOT scores. Conclusions: HBOT may be a good alternative treatment or adjunctive treatment for erectile dysfunction.

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Section: Discussionmentioning

confidence: 80%

The Effect of Hyperbaric Oxygen Therapy on Erectile Functions: A Prospective Clinical Study

et al. 2018

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“…These findings underlie the rationale for translational studies. Chiles et al published the first randomized, double-blind controlled trial of HBO vs. air for men after RP [139]. Although the authors were unable to demonstrate significant difference in IIEF score at 18 months, uncertainty about the proper regimen for therapy (total number and frequency of treatments) and lack of a true "sham" group may have limited their ability to detect a clinically relevant difference in outcome.…”

Section: Hyperbaric Oxygenmentioning

confidence: 99%

Preventing Erectile Dysfunction after Radical Prostatectomy: Nerve-Sparing Techniques, Penile Rehabilitation, and Novel Regenerative Therapies

Whalen¹

2019

Prostatectomy

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Erectile dysfunction is a known and much-dreaded functional consequence of radical prostatectomy. Dr. Patrick Walsh pioneered the nerve-sparing radical retropubic prostatectomy in the early 1980s, which has mitigated the morbidity of this surgery. Postoperative potency rates range widely from 20 to 80%, however, and depend on myriad factors including age, preoperative potency, and degree of nerve-sparing during surgery. Over the past four decades several developments have continued to offer hope to patients and clinicians alike, including refined understanding of cavernosal nerve neuroanatomy, beneficial modifications in surgical technique, as well as the advent of robotic surgery. Furthermore, multiple pre-and post-operative penile rehabilitation techniques using mechanotherapy and pharmaceuticals have also improved functional recovery. This paper examines erectile dysfunction as a consequence of radical prostatectomy, including the physiology of erections, the pathophysiology of post-operative erectile dysfunction, novel surgical techniques to enhance neurovascular bundle preservation, and penile rehabilitation strategies involving hyperbaric oxygen, neuroprotective pharmaceuticals, dehydrated human amnion-chorion membrane allografts, and mesenchymal stem cell therapy.

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“…It has, therefore, been hypothesized that prolonged tissue hypoxia due to the absence of erections may be a causative factor in permanent ED after surgery [13]. To address this, Chiles and colleagues randomized patients to hyperbaric 100% oxygen or hyperbaric air therapy shortly after radical prostatectomy [14]. Although they reported treatment to be safe, they did not find hyperbaric oxygen significantly improved erectile function.…”

Section: New Insights-mechanismsmentioning

confidence: 99%

Penile Rehabilitation: the “Up”-date

Gabrielsen

2018

Curr Sex Health Rep

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Purpose of Review: The purpose of this review is to review the penile rehabilitation literature published since the beginning of 2017. Specific emphasis was placed on determining how the new findings increase our understanding of the mechanisms leading to recovery of erectile function after pelvic surgery and to identify potential focus areas for future studies. Recent Findings: A meta-analysis of penile rehabilitation after prostatectomy was published in early 2017 reporting that PDE-5 inhibitors, intracavernosal injection (ICI) therapy and vacuum erection devices (VED) improved erectile function; however, the benefit was not observed after a washout period. Preclinical studies have identified potential regenerative therapies after cavernous nerve injury. Summary: While significant methodological challenges remain, recent literature suggests benefits to starting penile rehabilitation immediately after surgery, but not extending past 1 year post-operatively. The cost-benefit ratio of penile rehabilitation remains unclear; however, decreasing costs of PDE-5 inhibitors as well as improvements in characterizing post-surgical erectile dysfunction may help to personalize penile rehabilitation, improve outcomes and improve the cost-benefit ratio. Better and more consistent trial design is needed to develop the optimal regimen(s) for restoring sexual function in men. Finally, future studies to translate promising preclinical regeneration therapies to humans are also needed.

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A Double-Blind, Randomized Trial on the Efficacy and Safety of Hyperbaric Oxygenation Therapy in the Preservation of Erectile Function after Radical Prostatectomy

Cited by 29 publications

References 14 publications

The Effect of Hyperbaric Oxygen Therapy on Erectile Functions: A Prospective Clinical Study

The Effect of Hyperbaric Oxygen Therapy on Erectile Functions: A Prospective Clinical Study

Preventing Erectile Dysfunction after Radical Prostatectomy: Nerve-Sparing Techniques, Penile Rehabilitation, and Novel Regenerative Therapies

Penile Rehabilitation: the “Up”-date

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