title: Long-term potency after early use of a vacuum erection device following radical prostatectomy.
abstract: OBJECTIVE
  To evaluate the long-term potency after radical prostatectomy (RP) with the early use of a vacuum erection device (VED), and reasons for sexual inactivity and long-term attrition and maintenance of sexual activity, as RP is one of the most common treatments for prostate cancer but erectile dysfunction (ED) is a common side-effect.
  
  
  METHODS
  We identified 141 sexually active patients who underwent RP at Cleveland Clinic Foundation. Patients were offered various non-oral treatment options to prevent ED and were also motivated for early penile rehabilitation. At 5 years 62% remained sexually active, of whom 71% had natural erections sufficient for intercourse without assistance, 8.5% were still using sildenafil, 10% were using combined therapy (sildenafil plus VED). At 5 years 38% (43/113) men were sexually inactive. The reasons included loss of interest in 17 (40%), cardiovascular/neurological diseases in 18 (42%), hormonal therapy in three (7%), loss of partner in three (7%) and two had other surgery. The natural rate of erections for sufficient vaginal penetration without an erection aid were preserved and maintained in the early-prophylaxis group, and almost 60% of them had used a VED as early prophylaxis.
  
  
  CONCLUSIONS
  Despite current phosphodiesterase-5 inhibitor treatments for ED, VED is becoming recognized again as having a primary role in early penile rehabilitation in many patients, specifically those treated for prostate cancer.
authors.affiliation: Department of Urology, Case Medical Center, Cleveland, OH, USA.
authors.forename: Rupesh
authors.initials: R
authors.lastname: Raina
authors.forename: Geetu
authors.initials: G
authors.lastname: Pahlajani
authors.forename: Ashok
authors.initials: A
authors.lastname: Agarwal
authors.forename: Stephen
authors.initials: S
authors.lastname: Jones
authors.forename: Craig
authors.initials: C
authors.lastname: Zippe
mesh_terms: D000368:Aged; D006801:Humans; D018783:Impotence, Vasculogenic / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000502:physiology*; D015917:Penile Prosthesis; D011468:Prostatectomy / Q000009:adverse effects / Q000534:rehabilitation*; D011471:Prostatic Neoplasms / Q000534:rehabilitation* / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D014618:Vacuum