Assessing vacuum erectile devices effect on post-radical prostatectomy erectile function

IF 0.4 Q4 NURSING

International Journal of Urological Nursing Pub Date : 2024-05-08 DOI:10.1111/ijun.12397

Mário Varandas RN, Tiago Santos MSc, RN, Daniela Dias MSc, RN, Inês Sousa MSc

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引用次数: 0

Abstract

Introduction and Objective

Radical prostatectomy, as a treatment for prostate cancer, could lead to erectile dysfunction (ED) which affects the sexuality of patients and may have significant psychological impact and in quality of life. Vacuum erectile devices (VED) have emerged as a non-invasive solution to aid post-prostatectomy ED recovery. This study aims to assess the gains in erectile function (EF) with VED usage in patients submitted to Retzius-sparing robot assisted radical prostatectomy (RS-RARP) at 6- and 12-months post-surgery.

Materials and Methods

Between January 2022 and September 2022 our center performed 46 RS-RARP, these patients had pre- and post-operative evaluations every 3 months during the first-year post-surgery, led by urology nursing team. If ED was identified and/or patient reported intention to improve EF a penile rehabilitation programme (PRP) that included VED usage was recommended. We conducted a prospective observational single-center study where EF was assessed using the International Index of Erectile Function (IIEF-5) at 6- and 12-months post-surgery. We compared the results of patients that had IIEF-5 score <15 at 6-month mark and started using VED, with IIEF-5 score at 12-month mark. The inclusion criteria are: patients that did not have adjuvant or salvage treatments during the follow up; have post-operative evaluations with IIEF-5 at 6 and 12 months and started PRP. A total of 43 patients were included. We have considered ED rehabilitation if the patient had at least 5 points gain on IIEF-5 score at 12 months versus IIEF-5 at 6 months. Every patient provided written informed consent for study inclusion, approved by the Institutional Ethics Committee (Approval 07.07.2017).

Results

From the total of patients included, 22 had an IIEF-5 score <15 at 6-month mark. We recommended VED to 7 patients and 4 used a VED regularly. Regarding patients that used VED, 3 had better IIEF-5 score at 12-month mark comparing to 6-month mark, with an average gain of 7,75 in IIEF-5 score. Regarding the total of patients (n = 43), 16 still had IIEF-5 score <15 at 12-month mark.

Conclusion

This observational study underscores the potential benefits of VED in aiding EF recovery post RS-RARP. Regular use of VED demonstrated significant improvement in IIEF-5 score at 12-month mark. Our findings suggest that integrating VED into the post RS-RARP rehabilitation care plan could serve as an effective strategy for patients that do not respond effectively to phosphodiesterase type 5 inhibitors. Study limitations are small sample of patients that used VED and not having a stablished VED protocol. Further controlled trials are warranted to validate these findings and explore long-terms effects.

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评估真空勃起装置对根治性前列腺切除术后勃起功能的影响

导言和目的作为前列腺癌的一种治疗方法，根治性前列腺切除术可能会导致勃起功能障碍（ED），从而影响患者的性生活，并可能对心理和生活质量产生重大影响。真空勃起装置（VED）作为一种非侵入性的解决方案出现，有助于前列腺切除术后勃起功能障碍的恢复。本研究旨在评估接受保Retzius机器人辅助前列腺癌根治术（RS-RARP）的患者在术后6个月和12个月使用VED后勃起功能（EF）的改善情况。材料与方法 2022 年 1 月至 2022 年 9 月期间，本中心实施了 46 例 RS-RARP，这些患者在术后第一年内每 3 个月接受一次术前和术后评估，由泌尿科护理团队负责。如果发现ED和/或患者报告有意改善EF，则建议患者进行阴茎康复计划（PRP），其中包括使用VED。我们进行了一项前瞻性单中心观察研究，在术后 6 个月和 12 个月时使用国际勃起功能指数 (IIEF-5) 评估勃起功能。我们将 6 个月时 IIEF-5 评分为 15 分并开始使用 VED 的患者的结果与 12 个月时的 IIEF-5 评分进行了比较。纳入标准是：在随访期间未进行辅助或挽救治疗的患者；在术后 6 个月和 12 个月进行 IIEF-5 评估并开始使用 PRP 的患者。共纳入 43 名患者。如果患者术后 12 个月的 IIEF-5 评分比术后 6 个月的 IIEF-5 评分至少提高了 5 分，我们就将其视为 ED 康复。每位患者都提供了书面知情同意书，并获得了机构伦理委员会的批准（2017 年 7 月 7 日批准）。结果在所有纳入研究的患者中，22 名患者在 6 个月时的 IIEF-5 评分为 15 分。我们向 7 名患者推荐了 VED，4 名患者定期使用 VED。在使用 VED 的患者中，有 3 名患者在 12 个月时的 IIEF-5 评分优于 6 个月时的评分，IIEF-5 评分平均提高了 7.75 分。在所有患者（43 人）中，16 人在 12 个月时 IIEF-5 评分仍为 15 分。结论这项观察性研究强调了 VED 在帮助 RS-RARP 术后 EF 恢复方面的潜在益处。定期使用 VED 可显著改善 12 个月后的 IIEF-5 评分。我们的研究结果表明，将 VED 纳入 RS-RARP 术后康复护理计划可作为对 5 型磷酸二酯酶抑制剂无效患者的有效策略。研究的局限性在于使用 VED 的患者样本较少，而且没有制定 VED 方案。有必要进一步进行对照试验，以验证这些发现并探索其长期效果。

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来源期刊

International Journal of Urological Nursing 医学-护理

CiteScore

0.80

自引率

20.00%

发文量

审稿时长

>12 weeks

期刊介绍： International Journal of Urological Nursing is an international peer-reviewed Journal for all nurses, non-specialist and specialist, who care for individuals with urological disorders. It is relevant for nurses working in a variety of settings: inpatient care, outpatient care, ambulatory care, community care, operating departments and specialist clinics. The Journal covers the whole spectrum of urological nursing skills and knowledge. It supports the publication of local issues of relevance to a wider international community to disseminate good practice. The International Journal of Urological Nursing is clinically focused, evidence-based and welcomes contributions in the following clinical and non-clinical areas: -General Urology- Continence care- Oncology- Andrology- Stoma care- Paediatric urology- Men’s health- Uro-gynaecology- Reconstructive surgery- Clinical audit- Clinical governance- Nurse-led services- Reflective analysis- Education- Management- Research- Leadership The Journal welcomes original research papers, practice development papers and literature reviews. It also invites shorter papers such as case reports, critical commentary, reflective analysis and reports of audit, as well as contributions to regular sections such as the media reviews section. The International Journal of Urological Nursing supports the development of academic writing within the specialty and particularly welcomes papers from young researchers or practitioners who are seeking to build a publication profile.