AUA 2015 take-homes: Sexual function/dysfunction

Here are the AUA 2015 take-home messages on sexual/dysfunction, presented by Landon Trost, MD.

Landon Trost, MD
Sexual Function/Dysfunction
  • Results of ultrasound-guided evaluation of erectile dysfunction depend on the anatomic placement of the probe on the penis.

  • Vascular risk factors do not predict hemodynamic outcomes.

  • Failure to achieve full stretched penile length predicts veno-occlusive dysfunction.

  • Use of audiovisual stimulation did not affect total erectile rigidity or number of intracavernosal injections required for treatment.

  • De novo Peyronie’s disease occurred in 17.4% of 276 men following radical prostatectomy, suggesting a need to address the issue during preoperative counseling.

  • Percutaneous stent revascularization of the internal pudendal artery is safe and appears promising.

  • Analysis of eight studies of extracorporeal shock wave lithotripsy for ED showed safety and clinically significant, durable improvement overall and across the individual trials. 

  • Low-dose extracorporeal shock wave therapy improves erectile function in diabetic rats, and the effect is enhanced with the addition of sildenafil citrate (Viagra). Separately, researchers found that low-intensity pulsed ultrasound improved erections and restored endothelium and smooth muscle in diabetic rats.

  • Cultures of clinically non-infected implanted penile prostheses (IPPs) showed a threefold higher rate of positive cultures in uncoated versus coated devices.

  • A subcoronal incision for IPPs showed a 75% satisfaction rate and 3% infection rate at 90 days in >100 procedures.

  • Cardiac and pudendal arteries exhibited similar remodeling and calcium content, failing to support the hypothesis that ED precedes cardiovascular disease because of smaller arterial circumference.

  • Pericytes function as a cellular regenerator, suggesting a potential new target for ED therapy.

  • Pioglitazone (Actos) enhanced survival of pelvic ganglion in a preclinical model of pelvic nerve crush, suggesting a possible role in neuroprotection.

  • A study of timing of surgical repair for penile fracture showed that surgery initiated more than 8 hours after ER admission was associated with worse erectile function at 1 and 3 months.

  • Treatment of Peyronie’s disease was associated with a decrease in the rate of partners’ sexual dysfunction from 75% before treatment to 33.3% afterward.

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