Abstract
Oral pharmacotherapy fails to provide an adequate erection in approx 30 to 35% of all patients tried on this initial therapy, and at higher rates in those patients who have diabetes mellitus and those who have had radical pelvic cancer surgery. In those patients with initial success from oral pharmacotherapy, there have been few reports of complete tachyphylaxis, although many who are started on lower doses initially feel that they obtain better results from the oral therapy by increasing to the higher dose recommended for use. Dropout rates owing to intolerable side effects are rare with all of the phosphodiesterase inhibitors. Occasionally, some users of oral therapy cannot afford to continue the use of the oral agents and prefer a more economical treatment for their erectile dysfunction (ED). Vacuum therapy provides such a solution. Certainly, penile prostheses are less economical for such patients. If there is a progression of disease—such as Peyronie’s disease of a severe nature, or more fibrosis of sinus smooth muscle, such as that associated with diabetes mellitus—then a penile prosthesis may become the next step in therapy for the patient with ED.
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References
Lewis RW, Witherington R. (1997) Eternal vacuum therapy for erectile dysfunction: use and results. World J Urol 15:78–82.
Levine LA, Dimitriou RJ. (2001) Vacuum constriction and external erection devices in erectile dysfunction. Urol Clinics NA 28:335–341.
Korenman SG, Viosca SSP. (1992) Use of vacuum tumescence device in the management of impotence in men with a history of penile implant or severe pelvic disease. JAGS 40:61–64.
Moul MW, McLeod DG. (1989) Negative pressure devices in the explanted penile prosthesis population. J Urol 142:729–731.
Meinhardt W, Lycklama A, Nijeholt AAB, Kripman RF, Zwartendijk J. (1993) The negative pressure device for erectile disorders: when does it fail? J Urol 149:1285–1287.
Limoge J, Olin E, Kreder K, Donatucci CF. (1994) External vacuum therapy versus intracavernous autoinjection of vasoactive drugs in anticoagulated patients with erectile dysfunction: a study of safety. J Urol 151:478A.
Lewis RW, Jordan GH. (2002) Surgery for Erectile Dysfunction. In: Walsh PC, Retnik AB, Vaughan ED Jr., et al., eds., Campbell’s Urology, 8th Ed., Philadelphia, PA: Saunders, pp. 1673–1709.
Soderdahl DW, Betroski RA, Mode D, Schwartz BF, Thrasher JB. (1997) The use of an external vacuum device to augment a penile prosthesis. Tech Urol 3:100–102.
Mulcahy JJ. (1997) Overview of penile implants. In: Mulcahy JJ, ed., Topics in Clinical Urology: Diagnosis and Management of Male Sexual Dysfunction. New York, NY: Igaku-Shoin, pp. 218–230.
Wang R, Lewis RW. (2000) Penile Implants—types and current indications. In: Mulcahy JJ, ed., Current Urology Series on Male Sexual Dysfunction: A Guide to Clinical Management. Totowa, NJ: Humana Press, pp. 263–277.
Wang R, Lewis RW. (2002) Reoperation for penile prosthesis implantation. In: Carson CC, ed., Urologic Prostheses. Totowa, NJ: Humana Press, pp. 231–247.
Ball TP. (1980) Surgical repair of the “SST” deformity. Urol 15:603–604.
Rajpurkar A, Dhabuwala B. (2003) Comparison of satisfaction rates and erectile function in patients treated with sildenafil, intracavernous prostaglandin E1 and penile implant surgery for erectile dysfunction in urology practice. J Urol 170:159–163.
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© 2005 Humana Press Inc., Totowa, NJ
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Lewis, R.W. (2005). Sustaining the Cure. In: Broderick, G.A. (eds) Oral Pharmacotherapy for Male Sexual Dysfunction. Current Clinical Urology. Humana Press. https://doi.org/10.1385/1-59259-871-4:323
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DOI: https://doi.org/10.1385/1-59259-871-4:323
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