Causes of erectile dysfunction after transurethral resection of hyperplastic prostate and its prevention


Cite item

Full Text

Abstract

The study was made of 60 sexually active patients with prostatic hyperplasia after monopolar transurethral operations (mean age 61.3 years). 30 patients entered a control group, 30 ones - the study group. The latter received 10 mg vardenafil each other day for 7 weeks after the intervention. The patients filled in questionnaire, underwent dopplerography and electromyography of the penis. Questionnaire said that erection was worse after operation in 6 (20%) patients (p < 0.01) of the control group and none of the study group. The latter also showed better circulation. All the men with postoperative erectile dysfunction (ED) had electromyographic signs of impaired autonomic innervation of the penis. Thus, ED after transurethral operations for prostatic hyperplasia is primarily neurogenic and is seen in 20% operated patients. Early vardenafil therapy is effective in prevention of postoperative ED.

References

  1. Винаров А. 3., Асламазов Э. Г. Гиперплазия предстательной железы. Современное лечение. В кн.: Материалы X Российского съезда урологов. Москва, 1-3 окт. 2002 г. М.: Информполиграф; 2002. 33-42.
  2. Горшовский Л. М. (ред.) Избранные главы гериатрической урологии. М.: Ньюдиамед; 2000.
  3. Мартов А. Г. Трансуретральная резекция (ТУР) в лечении доброкачественной гиперплазии предстательной железы. В кн.: Лопаткин Н. А. (ред.) Доброкачественная гиперплазия предстательной железы. М.; 1999. 193-209.
  4. Seki N., Naito S., Oshima S. et al. Prevalence and preference with regard to various surgical treatments for benign prostatic hypertrophy: a survey for the Japanese endourology and ESWL society member. Nippon Hinyokika Gakkai Zasshi 2003; 94 (4): 495-502.
  5. Bieri S., Iselin С. Е., Rohner S. Capsular perforation localization and adenoma size as prognostic indicators of erectile dysfunction after transurethral prostatectomy. Scand. J. Urol. Nephrol. 1997; 31: 545-548.
  6. Bruskewitz R. C., Larsen E. H., Madsen P. O., Dorflinger T. 3year follow-up of urinary symptoms after transurethral resection of the prostate. J. Urol. (Baltimore) 1986; 136 (3): 613-663.
  7. Uygur M. C., Gur E., Arik A. I. et al. Erectile dysfunction following treatments of benign prostatic hyperplasia: a prospective study. Andrologia 1998; 30 (1): 5-10.
  8. Bolt J. W., Evans C., Marshall V. R. Sexual dysfunction after prostatectomy. Br. J. Urol. 1986; 58: 319.
  9. Finkle A. L., Prian D. V. Sexual potency in elderly men before and after prostatectomy. J. A. M. A. 1966; 196: 139.
  10. Hammadeh M., Madaan S., Singh M., Philp T. Transurethral electrovaporisation of the prostate; a possible alternative to standard TURP. Three year follow-up of a prospectively randomised trial. J. Urol. (Baltimore) 1999; 161: 391.
  11. Hargreave Т. В., Strephensen T. P. Potency and prostatectomy. Br. J. Urol. 1977; 49: 683.
  12. Holtgrewe H. L., Valk W. L. Late results of transurethral prostatectomy. J. Urol. (Baltimore) 1964; 92: 51.
  13. Libman E., Fichten C. S. Prostatectomy and sexual functions. Urology 1987; 29: 467.
  14. Mebust W. K., Holtgrewe H. L., Cockett A. Т. К. et al. Transurethral prostatectomy: immediate and postoperative complications. A cooperative study of 13 participating institutions evaluating 3885 patients. J. Urol. (Baltimore) 1989; 141: 243.
  15. Коган М. И. Возможно ли до выполнения трансуретральной или открытой аденомэктомии простаты прогнозировать развитие после операции эректильной импотенции? В кн.: Материалы Пленума Всероссийского науч. о-ва урологов, Курск, 27-28 мая 1993 г. М.; 1993. 92-93.
  16. Vale J. Benign prostatic hyperplasia and erectile dysfunction - is there a link? Curr. Med. Res. Opin. 2000; 16 (1): s63-s67.
  17. Камалов А. А., Ковалев В. А., Ефремов Е. А. Этиологические факторы эректильной дисфункции у пациентов, перенесших трансуретральные эндоскопические вмешательства. В кн.: Материалы Всероссийской конф. «Мужское здоровье», Москва, 19-21 нояб. 2003 г. М.; 2003. 151 - 152.
  18. Lefaucheur J. P., Yiou R., Salomon L. et al. Assessment of penile small nerve fiber damage after transurethral resection of the prostate by measurement of penile thermal sensation. J. Urol. (Baltimore) 2000; 164(4): 1416-1419.
  19. Padma-Nathan H., Goldstein I. The pathogenesis of post-TURP impotence. J. Urol. (Baltimore) 1988; 139: 275A.
  20. Brock G., Nehra A., Lipshultz L. I. et al. Safety and efficacy of vardenafil for the treatment of men with erectile dysfunction after radical retropubic prostatectomy. J. Urol. (Baltimore) 2003; 170 (4, pt 1): 1278-1283.
  21. Goldstein I., Lue T. F., Padma-Nathan H. et al. Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group. N. Engl. J. Med. 1998; 338 (20): 1397-1404.
  22. Lue T. Impotence after radical pelvic surgery: physiology and management. Urol. Int. 1991; 46: 259.
  23. Zohar J., Meiraz D., Maoz В., Durst N. Factors influencing sexual activity after prostatectomy: A prospective study. J. Urol. (Baltimore) 1976; 116: 332-334.
  24. Горюнов В. Г., Давидов М. И. Сексуальная реадаптация после оперативного лечения доброкачественной гиперплазии простаты. Урология 1997; 5: 20-24.
  25. Lue Т. F. Impotence after prostatectomy. Urol. Clin. N. Am. 1990; 17 (3): 613-620.
  26. Mitchell J. P., Lumb G. N. A handbook of surgical diathermy. Bristol: John Wright & Sons Ltd.; 1966.
  27. Padma-Nathan H., Goldstein I. The pathogenesis of post-TURP impotence. J. Urol. (Baltimore) 1988; 139: 275A.
  28. Mofferdin A., Sighinolfl M. C., De Stefani S. et al. Changes in peak systolic velocity induced by chronic therapy with sildenafil citrate. In: The Abstracts of the 19-th Congress of EAU, Vienna, 24-27 March 2004. Vienna; 2004. 400.
  29. Parsons С. I. Impotence following transurethral resection of the prostate. In: Rajfer J., ed. Common problems in infertility and impotence. Chicago: Year Book Medical; 1990.
  30. Zippe С. D., Kedia A. W., Kedia K. et al. Treatment of erectile dysfunction after radical prostatectomy with sildenafil citrate (Viagra). Urology 1998; 52: 963-966.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2005 Bionika Media

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies