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