Table 2. Penile rehabilitation after radical prostatectomy: summary of clinical trials using non-oral modalities.
Author | Year | N | Follow-up | Study design | ED treatment (treatment period) | Level of evidence | Significant findings |
---|---|---|---|---|---|---|---|
McCullough et al. (33) | 2010 | 212 | 9 months | Prospective, randomized | IUA vs. sildenafil (9 months) | 2 | No difference in IIEF and intercourse success between treatments |
Montorsi et al. (34) | 1997 | 30 | 12 weeks | Prospective randomized | ICI vs. no treatment (12 weeks) | 2 | ICI has higher rate of spontaneous erections compared with controls |
Mulhall et al. (35) | 2005 | 132 | 18 months | Prospective, non-randomized | Sildenafil +/− ICI (12 months) | 3 | Treatment group had more spontaneous erections and higher IIEF compared with controls. Men on rehabilitation are more likely to respond to treatment |
Mulhall et al. (36) | 2009 | 84 | 2 years | Retrospective, no control | Sildenafil +/− ICI: early (2 months) vs. delayed (7 months) | 4 | Early better than delayed group in unassisted erections |
Raina et al. (37) | 2006 | 109 | 9 months | Prospective, randomized | Daily VED vs. no treatment | 2 | VED improved rate of spontaneous erections and decreased penile shrinkage |
Raina et al. (38) | 2010 | 141 | 5 years | Prospective, non-randomized | VED and other non-oral therapies (9 months) | 3 | Most men who tried non-oral agents, with or without VED, remained sexually active after 5 years |
Engel et al. (39) | 2011 | 23 | 12 months | Prospective, randomized | VED and tadalafil vs. tadalafil | 2 | Combination therapy had higher IIEF scores |
Fode et al. (40) | 2014 | 68 | 18 months | Retrospective | PVS with PDE5I vs. no PVS with PDE5I (6 weeks) | 3 | No significant difference, though trend of better IIEF score in patients using PVS |
Yiou et al. (41) | 2015 | 12 | 1 year | Phase I–II, no-control | ICSCT | 4 | Significant improvement in IIEF scores compared to baseline. Well tolerated |
VED, vacuum erection devices; IUA, intraurethral alprostadil; ICI, intracavernosal injection therapy; PVS, penile vibratory stimulation; IIEF, international index of erectile function score; ICSCT, intracavernosal stem cell therapy.