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- W2085515988 abstract "You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Medical and Non-Surgical Therapy I1 Apr 2015PD37-12 DAILY TADALAFIL DOES NOT INCREASE PRIAPISM RATES IN AN INTRACAVERNOSAL INJECTION (ICI) REHABILITATION PROGRAM, AFTER RADICAL PROSTATECTOMY (RP) Eduardo Miranda, Serkan Deveci, Lawrence Jenkins, Joseph Narus, and John Mulhall Eduardo MirandaEduardo Miranda More articles by this author , Serkan DeveciSerkan Deveci More articles by this author , Lawrence JenkinsLawrence Jenkins More articles by this author , Joseph NarusJoseph Narus More articles by this author , and John MulhallJohn Mulhall More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2274AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES PDE5 inhibitor (PDE5i) labeling states that these agents should not be used in conjunction with other erectogenic medications for fear of priapism occurring. Tadalafil 5mg daily reaches a peak serum level of approximately 8mg after 5 days and remains at erectogenic serum levels at all times. We explored the risk of priapism in men in our post-radical prostatectomy (RP) penile injection program who were using regular PDE5i as part of their rehabilitation program. METHODS Study cohort included men on penile injection therapy who (i) were taking tadalafil 5mg daily or taking sildenafil 25mg on non-injection days (ii) had a RP (iii) were using their respective PDE5i regularly at the time of penile injection training and (iv) complied with the program instructions regarding penile injection use. Demographics, comorbidity details, PDE5i dose and utilization as well as injection dose and utilization data were collected. All patients underwent in-office injection training and used trimix (papaverine/phentolamine/PGE1) as the intracavernosal medication. Priapism was defined as a patient self-reported penetration hardness erection ≥4 hours in duration, while prolonged erection was defined as a penetration hardness erection lasting ≥2 hours. RESULTS 112 tadalafil (T) users and 364 sildenafil (S) users were compared. Mean age and duration post-RP were 62±14 years and 5.2±12 months respectively, no difference between T and S groups. Mean trimix dose was: T 24±24 units; S 31±37 units, p<0.05. Priapism occurred in: T 2/112 (1.7%); S 5/364 (1.4%), p=0.47. Excluding those men experiencing priapism on any occasion, those with any reported penetration hardness erection lasting ≥2 hours: T 7/110 (6.3%); S 12/359 (3.3%), p<0.01. 53% of these prolonged erections occurred within the first 6 injections at home (no difference between T and S groups). CONCLUSIONS No difference in priapism event rates existed between T and S users in this analysis. However, the mean trimix dose was higher for men using T and the proportion of men using T who experienced a prolonged erection not requiring an emergency room visit was also higher. While both strategies (T and S) appear safe in the penile injection population, excellent patient counseling is required especially for men using T. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e774-e775 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Eduardo Miranda More articles by this author Serkan Deveci More articles by this author Lawrence Jenkins More articles by this author Joseph Narus More articles by this author John Mulhall More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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- W2085515988 title "PD37-12 DAILY TADALAFIL DOES NOT INCREASE PRIAPISM RATES IN AN INTRACAVERNOSAL INJECTION (ICI) REHABILITATION PROGRAM, AFTER RADICAL PROSTATECTOMY (RP)" @default.
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