[Evaluation of visual stimulation combined with intracavernous injections for the treatment of severe erectile dysfunction].
OBJECTIVE
To assess the value of visual sexual stimulation combined with intracavernous injections (ICI) in patients treated for severe erectile dysfunction.


METHODS
All patients with severe erectile dysfunction were prospectively included in this study between 2005 and 2006. The outpatient protocol consisted of comparing the efficacy of alprostadil ICI alone on D0 and ICI combined with erotic stimulation on D8. End-points were: time to onset and rigidity of erection. A subjective score (1 to 5) was used to quantify erection.


RESULTS
Forty patients with a mean age of 64.5 years (range: 52-70 years) were included in the study. All patients had an IIEF5 score less than 15. Erectile dysfunction was secondary to urological surgery in 35% of cases. The mean time to onset of erection was 10 min 18 s (range: 2-20 min) on D0 and 10 min 50 s (range: 2-20 min) on D8. No significant difference for rigidity and quality of erection was observed between D0 and D8 and erections were scored as 5 in 30 cases (75%), 4 in 8 cases (20%) and 3 in 2 cases (5%) at each visit.


CONCLUSIONS
Visual sexual stimulation has not been demonstrated to be truly effective in the hospital setting in combination with intracavernous injections. In order to increase the patient satisfaction rate, the urologist must above all educate the patient in the intracavernous injection technique in an appropriate environment.
Galiano
Marc
M
Service d'urologie et de transplantation renale et pancréatique, Hôpital Pitié-Salpêtrière, Paris, France.
Rouprêt
Morgan
M
Beley
Sébastien
S
Gattegno
Bernard
B
Chartier-Kastler
Emmanuel
E
Richard
François
F
D000368:Aged; D000527:Alprostadil / Q000008:administration & dosage*; D001296:Audiovisual Aids; D015653:Cystectomy; D007172:Erectile Dysfunction / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000187:drug effects / Q000502:physiology; D010775:Photic Stimulation; D011446:Prospective Studies; D011468:Prostatectomy; D013997:Time Factors; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage*
D014665:Vasodilator Agents; D000527:Alprostadil