The effect of cryosurgical ablation of the prostate on erectile function.
OBJECTIVE
To investigate the incidence and identify the possible cause of erectile dysfunction after cryoablation of the prostate.


METHODS
Erectile function was examined prospectively in 15 sexually active men (aged 59-72 years) who underwent cryoablation of the prostate for clinically localized prostate cancer. Erectile function was assessed before and 6 months after treatment; after intracavernosal injection with 10 micrograms of prostaglandin E1 (PGE1), the degree and duration of erection, the size of the cavernosal arteries, the penile arterial blood flow velocity, and the time to achieve peak flow were evaluated using high-resolution ultrasonography and colour pulsed-Doppler spectral analysis.


RESULTS
Post-operatively, all patients initially reported an inability to achieve an erection sufficient for vaginal intercourse. At 6 months' follow-up, erectile dysfunction persisted in nine, with minimal or no response to the intracavernosal PGE1 injections, there was a significant decrease in the peak velocity of blood flow within cavernosal arteries and a significant increase in the time to achieve peak arterial flow.


CONCLUSIONS
Although many factors may contribute to erectile dysfunction after cryoablation of the prostate, vascular injury plays a major role.
Aboseif
S
S
Department of Urology, University of California School of Medicine, San Francisco, USA.
Shinohara
K
K
Borirakchanyavat
S
S
Deirmenjian
J
J
Carroll
P R
PR
D000368:Aged; D000527:Alprostadil / Q000627:therapeutic use; D001783:Blood Flow Velocity; D003452:Cryosurgery / Q000009:adverse effects*; D007172:Erectile Dysfunction / Q000209:etiology*; D006801:Humans; D018783:Impotence, Vasculogenic / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D010413:Penis / Q000098:blood supply; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000601:surgery*; D018617:Ultrasonography, Doppler, Pulsed; D014665:Vasodilator Agents / Q000627:therapeutic use*
D014665:Vasodilator Agents; D000527:Alprostadil