Sexual function/dysfunction topics discussed at the 2016 AUA included the findings of multiple studies on the effects of collagenase clostridium histolyticum (Xiaflex) treatment for Peyronie's disease, causes and treatments for ED, along with a study on patient satisfaction with implantable penile prostheses.
Ryan P. Terlecki, MDSexual function/dysfunction topics discussed at the 2016 AUA included the findings of multiple studies on the effects of collagenase clostridium histolyticum (Xiaflex) treatment for Peyronie's disease, causes and treatments for ED, along with a study on patient satisfaction with implantable penile prostheses. The Sexual Function/Dysfunction discussions were presented by Ryan P. Terlecki, MD of Wake Forest University, Winston-Salem NC.
Mixed results were seen with several small clinical experiences with collagenase clostridium histolyticum (CCH [Xiaflex]) in Peyronie’s disease. In one study, 66 patients who received 1-4 series of injections noted a mean curvature improvement of 22°, with 80% of men finding their change to be meaningful. In a study of 78 men who completed four treatment cycles, a 16.5° change in curvature was reported. Six men had restoration of ability to engage in intercourse, and 33% of patients reported glans hypoesthesia. In a retrospective study, corporal rupture following injection was reported by 3.6% of patients. Thirty-four percent of surveyed surgeons reported witnessing this complication in practice, typically around 5 days after the last injection. A cost-analysis model found that CCH treatment was nine times more expensive than plication.
Working second or third shift and sleeping poorly may contribute to erectile dysfunction (ED).
Hypofractionated and conventional radiology for prostate cancer confer a comparable risk of ED.
Low-dose brachytherapy is associated with ED in a majority of patients, becoming most noticeable after 3 years. Another group noted that 75% of men with normal function before brachytherapy and who were younger than 60 years of age at treatment could have penetration 10 years later.
External beam radiation therapy commonly causes sensory disturbances in the penis, morphologic changes, and orgasmic dysfunction.
Low testosterone was observed in nearly 24% of patients with new-onset ED.