Has the efficacy of penile arterial by-pass surgery in the treatment of arteriogenic erectile dysfunction been determined?
The evaluation of the efficacy of penile arterial by-pass surgery (PABG) must be based on data obtained in clinical trials which have utilized a traditionally acceptable scientific design. A review of the studies which have presented the PABG surgical outcomes analysis revealed that patient selection and patient assignment have not been randomized. Demographic and individual variables, which could potentially influence outcomes, have not been eliminated by use of a marched pair design. Treatment options, including an option which allows assessment of effect of surgery per se, have not been presented in any of the studies. A majority of the studies have not blinded the researcher who analyzed the results. Commonly, follow-up evaluations have been limited and have not used converging sources of evidence. Practical suggestions are offered to improve future clinical trials so that the question of the efficacy of PABG surgery can be scientifically answered.
Vickers
K E
KE
Department of Psychology, Harvard University, Cambridge, Massachusetts, USA.
Vickers
M A
MA
D001158:Arteries / Q000601:surgery*; D002986:Clinical Trials as Topic; D006801:Humans; D018783:Impotence, Vasculogenic / Q000601:surgery*; D008297:Male; D010410:Penile Erection; D010413:Penis / Q000098:blood supply*; D012107:Research Design / Q000592:standards