Is there an optimal time for intracavernous XXXX rehabilitation following nonnerve sparing radical prostatectomy? Results from a hemodynamic prospective study.

@entity1 @entity5015 @entity5501
PURPOSE: Previous studies have shown that early intracavernous @entity5015 injection may reduce significantly the incidence of @entity5501 before spontaneous erections recover after nerve sparing radical prostatectomy. We identify the more convenient postoperative timing for successful intracavernous injection rehabilitation in a series of @entity1 who underwent nonnerve sparing radical prostatectomy. MATERIALS AND METHODS: A total of 73 @entity1 with a normal preoperative International Index of Erectile Function score were randomly allocated to undergo dynamic color Doppler ultrasound study 20 mg. @entity5015 at 1, 2 to 3, 4 to 6 and 7 to 12 months postoperatively, respectively. In all cases the peak systolic velocity, end diastolic velocity and resistance index were evaluated at 5, 10 and 20 minutes after injection. RESULTS: Of the @entity1 36 received the intracavernous injection within the first 3 months (group 1) and 37 received it at 4 to 12 months (group 2). A significantly higher proportion of group 1 @entity1 had grade 3 erection compared with group 2. Peak systolic velocity less than 30 cm. per second in at least 1 cavernosal artery was recorded in 22.2% of group 1 @entity1 and 51.3% of group 2 (p >0.05). CONCLUSIONS: Intracavernous injections after nonnerve sparing radical prostatectomy produce valid erectile responses in a significantly higher proportion of @entity1 when started within month 3 after the operation. Injection given in postoperative month 1 gives the best response rate but with significant complications and poor @entity1 compliance. Arteriogenic and venogenic factors seem to be involved with failure.
