Is it still clinically and economically viable in the <scp>UK</scp> to prescribe vacuum erection devices for patients with erectile dysfunction after radical prostatectomy?

Vasdev, Nikhil; Hoyland, Kimberley; Adshead, James

doi:10.1111/bju.12194

Cited by 5 publications

(2 citation statements)

References 4 publications

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“…Total treatment cost for such a period is estimated at £228 (including VAT) according to other studies. 21 This pricing takes into account additional cost of replacements rings. In contrast, cost for ICI over the same period is estimated between £2500–5000.…”

Section: Discussionmentioning

confidence: 99%

Erectile dysfunction after robotic radical prostatectomy: Real-life impact of vacuum erection device clinic

Juliebø‐Jones

Barba

Johnson

et al. 2020

Journal of Clinical Urology

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Introduction: Post-radical prostatectomy erectile dysfunction (post-RPED) is a common and potentially devastating complication. The role of PDE5-inhibitors (PDE5-Is) in post-RPED is controversial and invasive pharmacological treatments are associated with poor long-term compliance. Vacuum erection devices (VEDs) are a non-pharmacological alternative. Little data regarding VED efficacy and associated patient satisfaction in post-RPED exists. This study aimed to investigate the outcomes of VED therapy in a post-robot assisted radical prostatectomy (post-RARP) population. Methods: All men who underwent RARP at a single centre between February 2015 and October 2017 attended a nurse-led holistic-needs-assessment (HNA) appointment at 10 weeks post-RARP. All men identifying ED as a concern at HNA were offered dedicated nurse-led post-RPED clinic and VED clinic appointments. A cross-sectional survey of patient reported outcomes in these men was performed. Results: In total 137/539 (25%) men reported ED as a concern at HNA. All 137 men attended the VED clinic, 124/137 (90%) responded to the survey. Commonest reason for choosing VED therapy was for combined psychological, penetration and lengthening purposes (48%). Median time from RARP to VED clinic and from VED clinic to survey was 122 days (range 56–595) and 462 days (range 66–932) respectively. At survey 88/124(70.9%) reported continued use of VED, 69/88 (78%) of this group perceived VED treatment to be successful. Of those who had stopped using VED, 7/36 (19%) felt it had been successful. Key reasons for discontinuation were either because men felt it ineffective (13/36 (37%)) or disliked the device (10/36 (29%)). Conclusion: VED therapy is an effective treatment for men with post-RARP ED that is well tolerated with good short- to medium-term compliance. Up to two-thirds of men may find overall satisfaction with their post-RPED after VED therapy. Level of Evidence: 3

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Section: Discussionmentioning

confidence: 99%

Erectile dysfunction after robotic radical prostatectomy: Real-life impact of vacuum erection device clinic

Juliebø‐Jones

Barba

Johnson

et al. 2020

Journal of Clinical Urology

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“…A vacuum erection device (VED) utilises negative pressure to boost arterial/venous inflow into the corpora cavernosum without a band for penile rehabilitation (Lin, Wang, & Wang, ; Qian, Gao, Wei, & Yuan, ). Numerous studies have widely demonstrated the benefits of a VED for erectile function in patients who developed ED due to radical prostatectomy (Lin, Yang, Zhang, Dai, & Wang, ; Vasdev, Hoyland, & Adshead, ; Welliver, Mechlin, Goodwin, Alukal, & McCullough, ). Until recently, only one clinical trial had used VED therapy for the treatment of patients with PD, with its preliminary results showing positive outcomes for reduced Peyronie's‐like plaque size (Raheem et al., ).…”

Section: Introductionmentioning

confidence: 99%

Reduction in Peyronie's-like plaque size using a vacuum erection device in a rat model of Peyronie's disease via the TGF-β/SMAD signalling pathway

Wang

Qin

et al. 2018

Andrologia

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Peyronie's disease (PD) is a fibrotic disorder of the tunica albuginea (TA). This study aimed to determine the therapeutic effects of a vacuum erection device (VED) in an animal model of PD and explore the possible mechanisms. Twenty-seven male Sprague-Dawley rats were used. The sham group (group A) (N = 9) received a 50-μl-saline vehicle injection into the TA, while the remaining 18 rats (groups B and C) received a TGF-β1 injection into the TA. The treatment group (group C) underwent VED therapy for 10 days after the TGF-β1 injection. Erectile function was then assessed at day 42. Rats injected with TGF-β1 showed significantly lower intracavernous pressures than those in the sham group (p < 0.0001). After VED therapy, erectile function was significantly better in the treatment group than in the PD group (group B) (p < 0.0147). Masson's trichrome staining confirmed Peyronie's-like plaques at the TGF-β1 injection site in the PD group. Furthermore, the treatment group showed markedly smaller fibrotic plaque sizes than the PD group. A significant increase in TGF-β1, SMAD2, SMAD3 and p-SMAD2/3 protein expression was observed 6 weeks after the TGF-β1 injection. However, the expression of the same proteins decreased after VED therapy. Protein expression trends were confirmed using immunohistochemistry analysis. The findings of this study demonstrate that VED therapy can reduce Peyronie's-like plaque size in a rat model of PD while simultaneously improving erectile function.

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Vacuum Therapy for Erectile Dysfunction

Hecht¹,

Hedges²

2016

Contemporary Treatment of Erectile Dysfunction

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Is it still clinically and economically viable in the UK to prescribe vacuum erection devices for patients with erectile dysfunction after radical prostatectomy?

Cited by 5 publications

References 4 publications

Erectile dysfunction after robotic radical prostatectomy: Real-life impact of vacuum erection device clinic

Erectile dysfunction after robotic radical prostatectomy: Real-life impact of vacuum erection device clinic

Reduction in Peyronie's-like plaque size using a vacuum erection device in a rat model of Peyronie's disease via the TGF-β/SMAD signalling pathway

Vacuum Therapy for Erectile Dysfunction

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