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• W2046607194 abstract "No AccessJournal of UrologyClinical Urology: Original Articles1 Oct 1998EFFICACY AND SAFETY OF TRANSURETHRAL ALPROSTADIL IN PATIENTS WITH ERECTILE DYSFUNCTION FOLLOWING RADICAL PROSTATECTOMY RAYMOND A. COSTABILE, MARIANNE SPEVAK, IRVING J. FISHMAN, FRED E. GOVIER, WAYNE J.G. HELLSTROM, RIDWAN SHABSIGH, KERRY J. NEMO, JOSHUA L. RAPPORT, PETER Y. TAM, KARA L.M. WELDON, and NEIL GESUNDHEIT RAYMOND A. COSTABILERAYMOND A. COSTABILE More articles by this author , MARIANNE SPEVAKMARIANNE SPEVAK More articles by this author , IRVING J. FISHMANIRVING J. FISHMAN More articles by this author , FRED E. GOVIERFRED E. GOVIER More articles by this author , WAYNE J.G. HELLSTROMWAYNE J.G. HELLSTROM More articles by this author , RIDWAN SHABSIGHRIDWAN SHABSIGH More articles by this author , KERRY J. NEMOKERRY J. NEMO More articles by this author , JOSHUA L. RAPPORTJOSHUA L. RAPPORT More articles by this author , PETER Y. TAMPETER Y. TAM More articles by this author , KARA L.M. WELDONKARA L.M. WELDON More articles by this author , and NEIL GESUNDHEITNEIL GESUNDHEIT More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)62527-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: A retrospective analysis of the MUSE* VIVUS, Inc., Menlo Park, California. clinical trial was performed to evaluate the efficacy and safety of transurethral alprostadil in patients with erectile dysfunction after radical prostatectomy. Materials and Methods: Patients received doses of transurethral alprostadil in the clinic and those for whom a suitable dose was determined were treated at home with active drug or placebo for 3 months. Patients had undergone radical prostatectomy no less than 3 months before study entry. Results: Of the 384 patients in whom radical prostatectomy was identified as a cause of erectile dysfunction 70.3% had an erection believed sufficient for intercourse in the clinic and 57.1% on active medication had sexual intercourse at least once at home. The product of clinic and home success rates (70.3 x 57.1%) was an overall success rate (the likelihood of active treatment to lead to intercourse at home) of 40.1%. The frequency of most adverse effects of radical prostatectomy was comparable to that of other organic etiologies of erectile dysfunction (1,127 patients). The percentage of patients with hypotension in the clinic was lower after radical prostatectomy compared to other erectile dysfunction etiologies (0.8 versus 4.2%, p <0.001) but the percentage of patients with urethral pain/burning was higher (18.3 versus 10.4%, p = 0.027). No urinary tract infection, fibrosis or priapism occurred in the post-radical prostatectomy patients. Conclusions: Transurethral alprostadil is a well tolerated and efficacious method of treating erectile dysfunction after radical prostatectomy, although psychological changes associated with cancer and surgery may limit home response. The severe neurovascular deficit associated with prostatectomy neither limits the efficacy of transurethral alprostadil nor increases the risks. References 1 : Prostate cancer: where are we and where are we going?. Brit. J. Urol.1997; 79: 2. Google Scholar 2 SEER Cancer Statistics Review. Bethesda, MD: U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, National Cancer Institute1996. Google Scholar 3 Cancer Statistics, 1994. New York: American Cancer Society1994. Google Scholar 4 : Return of erections and urinary continence following nerve sparing radical retropubic prostatectomy. J. Urol.1993; 150: 905. Link, Google Scholar 5 : Nerve sparing radical prostatectomy: a different view. J. Urol.1995; 154: 145. Link, Google Scholar 6 : Sexual function following radical prostatectomy: influence of preservation of neurovascular bundles. J. Urol.1991; 145: 998. Link, Google Scholar 7 : Neuroanatomical approach to radical cystoprostatectomy with preservation of sexual function. J. Urol.1987; 138: 1402. Link, Google Scholar 8 : Impotence following radical prostatectomy: insight into etiology and prevention. J. Urol.1982; 128: 492. Link, Google Scholar 9 : Pharmacological treatment of erectile dysfunction after radical prostatectomy. J. Urol.1988; 139: 775. Abstract, Google Scholar 10 : Papaverine testing of impotent patients following nerve-sparing radical prostatectomy. J. Urol.1988; 139: 773. Link, Google Scholar 11 : National patterns of prostate cancer treatment by radical prostatectomy: results of a survey by the American College of Surgeons Commission on Cancer. J. Urol.1994; 152: 1817. Link, Google Scholar 12 : Radical retropubic prostatectomy: the influence of accessory pudendal arteries on the recovery of sexual function. J. Urol.1995; 154: 150. Link, Google Scholar 13 : Impact of moderate dose of postoperative radiation on urinary continence and potency in patients with prostate cancer treated with nerve sparing prostatectomy. J. Urol.1996; 155: 616. Link, Google Scholar 14 : The status of radical prostatectomy in the United States in 1993: where do we go from here? J. Urol.1994; 152: 1816. Abstract, Google Scholar 15 : Treatment of men with erectile dysfunction with transurethral alprostadil. New Engl. J. Med.1997; 336: 1. Google Scholar 16 : Sexual rehabilitation after treatment for prostate cancer. Cancer1993; 71: 1024. Google Scholar 17 : Patient-reported complications and follow-up treatment after radical prostatectomy. The National Medicare experience: 1988-1990. Urology1993; 42: 622. Google Scholar 18 : An assessment of radical prostatectomy. Time trends, geographic variation, and outcomes. The Prostate Patient Outcomes Research Team. J.A.M.A.1993; 269: 2633. Google Scholar 19 : How potent is potent before nerve sparing radical retropublic prostatectomy? J. Urol.1995; 154: 1100. Abstract, Google Scholar 20 : The combined use of sex therapy and intrapenile injections in the treatment of impotence. J. Sex. Marital Ther.1990; 16: 195. Google Scholar 21 : Quality-of-life outcomes in men treated for localized prostate cancer. J.A.M.A.1995; 273: 129. Crossref, Medline, Google Scholar From the Urology Service, Department of Surgery, Military Andrology Research Center, Walter Reed Army Medical Center, Washington, D. C., Baylor College of Medicine, Houston, Texas, Virginia Mason Medical Center, Seattle, Washington, Tulane University Medical Center, New Orleans, Louisiana, Columbia-Presbyterian Medical Center, New York, New York, and VIVUS, Inc., Mountain View, California© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byMATTHEW A, GOLDMAN A, TRACHTENBERG J, ROBINSON J, HORSBURGH S, CURRIE K and RITVO P (2018) SEXUAL DYSFUNCTION AFTER RADICAL PROSTATECTOMY: PREVALENCE, TREATMENTS, RESTRICTED USE OF TREATMENTS AND DISTRESSJournal of Urology, VOL. 174, NO. 6, (2105-2110), Online publication date: 1-Dec-2005.Lowentritt B, Scardino P, Miles B, Orejuela F, Schatte E, Slawin K, Elliott S and Kim E (2018) SILDENAFIL CITRATE AFTER RADICAL RETROPUBIC PROSTATECTOMYJournal of Urology, VOL. 162, NO. 5, (1614-1617), Online publication date: 1-Nov-1999. Volume 160Issue 4October 1998Page: 1325-1328 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information RAYMOND A. COSTABILE More articles by this author MARIANNE SPEVAK More articles by this author IRVING J. FISHMAN More articles by this author FRED E. GOVIER More articles by this author WAYNE J.G. HELLSTROM More articles by this author RIDWAN SHABSIGH More articles by this author KERRY J. NEMO More articles by this author JOSHUA L. RAPPORT More articles by this author PETER Y. TAM More articles by this author KARA L.M. WELDON More articles by this author NEIL GESUNDHEIT More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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