Medical Components of Psychosexual Pathways: Injection Therapy and Penile Prostheses
Domes et al.,  a cohort study was conducted with reasonable numbers (n = 117) and large loss to follow-up . Patients at varying stages of treatment post-surgery completed the IIEF short form questionnaire. Although the paper was of moderate quality , there was a large weakness was in study design. The cohorts had not been appropriately matched and not risk stratified according to degree of nerve sparing as part of the study. This can significantly impact of degree of psychosexual concerns, as patients with more extended nerve sparing, will have greater erectile dysfunction. This was also a retrospective analysis and that does not contribute to improving the strength of the study . Additionally, the doses of injection used are not specified, which is another bias in interpreting the results. The paper however does highlight the use of injection therapy as part of a pathway, emphasising the better level of support given to patients when combined as a pathway (Level 2a, recommendation B).
- 3.Megas G, Papadopoulos G, Stathouros G, Moschonas D, Gkialas I, Ntoumas K. Comparison of efficacy and satisfaction profile, between penile prosthesis implantation and oral PDE5 inhibitor Tadalafil therapy, in men with nerve-sparing radical prostatectomy erectile dysfunction. BJU Int. 2013;112:E169–76.CrossRefPubMedPubMedCentralGoogle Scholar
- 4.Pavlovich CP, Levinson AW, Su LM, Mettee LZ, Feng Z, Bivalacqua TJ, Trock BJ. Nightly vs on-demand sildenafil for penile rehabilitation after minimally invasive nerve-sparing radical prostatectomy: results of a randomized double-blind trial with placebo. BJU Int. 2013;112:844–51.CrossRefGoogle Scholar
- 5.Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ (Online). 2009;339:332–6.Google Scholar