OBJECTIVE: To examine the effect of penile vibratory stimulation (PVS) in the preservation and restoration of erectile function and urinary continence in conjunction with nerve-sparing radical prostatectomy.
SUBJECTS/PATIENTS AND METHODS: The study was conducted between July 2010 and March 2013 as a randomized prospective trial at two university hospitals. Eligible participants were continent men with an International Index of Erectile Function-5 (IIEF-5) score of at least 18, scheduled to undergo nerve sparing radical prostatectomy. Patients were randomized to a PVS group or a control group. Patients in the PVS group were instructed in using a PVS device (FERTI CARE® vibrator, Multicept A/S, Frederiksberg, Denmark). Stimulation was performed at the frenulum once daily by the patients in their own homes for a minimum of one week prior to surgery. After catheter removal, daily PVS was re-initiated for a period of six weeks. Participants were evaluated at 3, 6 and 12 months following surgery with the IIEF-5 questionnaire and questions regarding urinary bother. Patients useing up to 1 pad daily for security reasons only were considered continent. The study was registered at www.clinicaltrials.org (NCT01067261).
RESULTS: Data from 68 patients were available for analyses (30 patients randomized to PVS and 38 patients randomized to the control group). The IIEF-5 score was highest in the PVS group at all time points after surgery with a median score of 18 vs. 7.5 in the control group at 12 months (p=0.09), but the difference only reached borderline significance. At 12 months 16/30 (53%) patients in the PVS group had reached an IIEF-5 score of at least 18 while this was the case for 12/38 (32%) patients in the control group (P=0.07). There were no significant differences in the proportions of continent patients between groups at either 3, 6 or 12 months. At 12 months 90% of the PVS patients were continent while 94.7% of the control patients were continent (P=0.46).
CONCLUSION: Our study did not document significant effect of PVS. However, the method proved to be acceptable for most patients and there was a trend toward better erectile function with PVS. More studies are needed to explore this possible effect further.
Written by:
Fode M, Borre M, Ohl DA, Lichtbach J, Sønksen J. Are you the author?
Department of Urology, Herlev University Hospital, Herlev, Denmark.
Reference: BJU Int. 2013 Oct 15. Epub ahead of print.
doi: 10.1111/bju.12501
PubMed Abstract
PMID: 24127838
UroToday.com Prostate Cancer Section
