101 Prostate biopsy and erectile function impairment: Preliminary results

101 PROSTATE

BIOPSY

PRELIMINARY Chrisofos Athens

AND

ERECTILE

FUNCTION

IMPAIRMENT:

RESULTS

M., Skolarikos Medical

School,

A., Livadas

K., Delis A., Sopilidis

2nd Department

of Urology,

O., Deliveliotis

Athens,

Greece

erectile

function

102 SEXUAL FUNCTION RECOVERY TOMY BASED ON THE TECHNIQUE: SURGERY Colombel

C

M., Cnzin B., Fassi-Fehri

Claude Bernard France

University,

AFTER RADICAL LAPAROSCOPIC

H., Cherasse A., Marechal

Department

of Urology

PROSTATECVERSUS OPEN

J.M., G&t

and Transplantation

A., Martin X. Surgery, Lyon,

& OBJECTIVES: One of the main advantages of laparoscopic prostatectomy is the exposure and visualisation of posterior and lateral prostatic fascia that contain the neuro vascular bundles. Sexual function recovery is dependent on the quality of the dissection at this level, however the superiority of laparoscopic surgery has not been demonstrated. In this study, we report the results of a prospective study on sexual fnnction recovery following laparoscopic surgery compared to open surgery.

INTRODUCTION

INTRODUCTION following transrectal

& OBJECTIVES: To evaluate biopsy of the prostate.

impairment

MATERIAL & METHODS: Prostate biopsy was performed in 37 men due to an elevated serum PSA and/or abnormal findings on DRE. A questionnaire referring to erectile function (Clinical Therapeutics /Vol. 23, No 10,200l) was filled prior to and one month after the procedure. Four questions were graded from 0 to 5 and one from 1 to 5 according to patient’s answers, with 0 or 1 referring to impotence while 5 referring to normal erectile function. Thus, a total symptom score ranged from a minimum 1 to a maximum 25 was recorded for each patient. Paired t-test was used for statistical analysis,

& METHODS: Duration of the study was 1X months. Were included informed patients with normal sexual function before radical prostatectomy (RP), with the diagnosis of localized prostate cancer treated either (not randomized) by laparoscopic or open surgery with bilateral nerve sparing. Following surgery, patients had a complete evaluation of their sexual function At 1, 3, and 6 months. At 1 month patients were trained for intra cavernous injection of PGEl, optimal dose was defined and patients were encourage to use ICI until they recover acceptable erections. The end point of the study was to compare the recovery of sexual function, the rate of spontaneous erections, the rate and quantity of PGEl induced erections between the two groups: laparoscopic RF (n:36) and open RP (n:38).

MATERIAL

RESULTS:

RESULTS: All patients filled and returned the questionnaires. Mean patient age was 63.80 years (range 49 to 74 SD 6.5 1). Mean erectile function symptom score prior to biopsy was 15.72 (range 1 to 25 SD 6.88) compared to 14.30 (range 1 to 25 SD 6.77). This difference was statistically significant (p
Return to

1 Laoaroscooic en: 36~;s 11 (30,6 %)

1 Onen 1 F6’n: 38 pts 8 (21.1%)

I P

I

1 NS

95% CI 0.54-2.22).

Although

indicate that of the initial

1 End mints

the sample

size was small, the preliminary

prostate biopsy erectile status,

may

impair

patient’s

results

erectile

of

function

At 6 months, and in the case of bilateral nerve sparing, laparoscopic surgery seems to give better results in term of risks of post operative impotence refractory to PGEl intra cavernous injections. Factors of recovery have to be evaluated on a larger number of patients.

CONCLUSIONS:

103 REALITY DYSFUNCTION PATIENTS

OF

Solsona ->

E. Iborra

Instituto

Valenciano

INTRODUCTION

POST RADICAL TREATMENT WITH

I., Dumont

R., Rices

de Oncologia, & OBJECTIVES:

PROSTATECTOMY ERECTILE SILDENAFIL IN NON-SELECTED

J.V., Casanova

Urology,

Valencia, To know

situation among non-selected prostate cancer prostatectomy (RP) and the response to sildenafil.

the erectile patients

dysfunction treated

Mean age was 62.8 years old and they were followed

by

(ED) radical

for a median

of

CONCLUSIONS: Actually, we are trying to preserve more NVB if the patient desires potency. Even in patients with no possibility of NVB preservation, it is worthwhile to implement ED treatment with IIC during the first year and testing sildenafil 1OOmg afterwards. Urology

Supplements

3 (2004)

Nale D., Micic

S., Vuksanovic

Clinical

of Serbia, Clinic

A., Bojanic

WITH

SURGICAL

N.

Centre

of Urology,

Belgrade,

Serbia and Montenegro

Spain

3 1.7 months. Only 111 (62%) desired treatment. Ninety patients took sildenafil in the regimen we previously exposed; 27 (30%), 18 (20%), and 45 (50%) had complete, partial or non response to sildenafil respectively. Among the 27 complete responders, the most frequent period was between 18-24 months. The IIEF scored 6.515.7 points less compared to the initial IIEF. In the univariate analysis, neurovascular bundles (NVB) preservation, previous partial response and presence of spontaneous tumescence were significant for complete response, however only the latter kept its significance in the multivariate analysis.

European

DYSFUNCTION IN PATIENTS PENIS PLASTICA

J

MATERIAL & METHODS: Selection period was between 1998 and 2001. Patients filled in a modified IIEF questionnaire before RP. We tested sildenafil 1OOmg in 3 different periods; 3-6, 12 and 18-24 months after RP. In case of complete response they implement the IIEF again. RESULTS:

104 ORGANIC ERECTILE PHASE OF INDURATIO

No. 2, pp. 28

INTRODUCTION & OBJECTIVES: To establish incidence of erectile dysfunction in pts with induratio penis plastica (IPP) as well as coexistence with organic erectile dysfunction. MATERIAL & METHODS: 250 patients with IPP were examined. Mean age was 50.7511.3 years (rang 19-72). Clinical parameters for plaque examinations were number, size, location and the angle of penile curvature. Erectile function was examined according to laboratory analysis and penodynamic test, Duplex Doppler ultrasonography (DDU) as well as pharmaco-cavernosography. Criteria for nonnal arterial flow were: peak systolic velocity (PSV)>25cm/sec; and for normal veno-oclusive penile mechanism: complete clinical erectile response on PGE 1 and EDV < 4cmisec. In patients with PSV < 25cm/sec and incomplete clinical erectile response, even after reapplication, pharmaco-cavemosography was performed. The control group consisted of 50 impotent men without IPP. RESULTS: Patients were divided in two groups with regard to etiology of ED in impotent men with IPP and impotent men without IPP based on results of DUU and penodynamic test. In the group of impotent men with IPP significantly more often was recorded vasculogenic cause of ED (p