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abstract

abstract

676

Penile revascularization surgery in patients with diabetic erectile dysfunction: long term results

Kayigil, O1; Okulu, E2; Akdemir, F3

1: Yildirim Beyazit University Faculty of Medicine The Urology Clinics of Ankara Ataturk Training and Research Hospital, Turkey; 2: The Urology Clinics of Ankara Ataturk Training and Research Hospital, Turkey ; 3: The Urology Clinics of Terme State Hospital, Samsun, Turkey

Objective: To determine the overall long-term success of penile revascularization surgery in the treatment of vasculogenic erectile dysfunction and also to investigate the effect of risk factors on the results of a modified Furlow-Fisher technique. We completed our revascularization surgery results in our 50 erectile dysfunction patients having no risk factors except diabetes with a long term follow-up.

 Materials and Methods: Between 2004 and 2015, 225 patients with a mean age of 47.2 (range:23–73) years underwent penile revascularization surgery. Among them, 50 patients were diagnosed as having diabetes mellitus and completed the mean 60,94±1,34 months follow-up. Following the physical examination and assessment of blood tests, all the patients were referred to the internal medicine, neurology, psychiatry and anesthesiology departments for a routine interview. Before the operation, a urological assessment was made using color Doppler ultrasonography, cavernosometry, and electromyography of the corpus cavernosum (CC-EMG). At least five points of increase in the IIEF-5 score during the latest patient visit in the postoperative period compared with the preoperative period was regarded as improvement (surgical success).

Results: The mean preoperative and follow-up total IIEF scores were 28.1±5.7 and 42.2±6.3, respectively (p<0.05). The mean IIEF-5 scores were 8.3±2.2 and 17.7±2.1 preoperatively and at the end of follow-up, respectively (p<0.05). The mean score in the erectile function domain of IIEF was 11.6±3.4 before the operation and 21.7±6.1 at the end of follow-up (p<0.05). According to the IIEF-15,32 patients achieved a no-ED threshold value of >26. According to the IIEF-5, the surgery was again successful in 35 of 50 diabetic patients (70%).

Conclussions: We suggest that penile revascularization surgery could be an alternative choice before penile prosthesis implantation in those patients having no risk factors except diabetes which is under control.

Table 1. Preoperative distribution of number of patients according to ED status, etiology of ED and surgical success. Response of these patients to the operation are also represented

                                                            Postoperative distribution of number of  

                                                            patients according to surgical success

       Preoperative

       distribution of

       number of

       patients (%)  

 No. of patients

 achieving a no-ED

  cutoff score

 of >26 in IIEF-15

 after the operation (%)            

  Improvement

  (change in IIEF-5            

   score ≥5) (%)

     Failure

   (change in IIEF-5

     score <5) (%)

Preoperative erectile dysfunction status

Mild (22-25)

4 (8)

3 (9,3)

3 (75)

1 (25)

Mild-Modarate (17-21)

6 (12)

5 (15.62)

5 (83.33)

1 (16.66)

Moderate (11-16)

10 (20)

7 (21.87)

6 (60)

4 (40)

Severe (5-10)

30 (60)

17 (53.12)

20 (66.66)

13 (33.33)

TOTAL

50 (100)

32 (64)

35 (70)

15 (30)

Etiology

Arteriogenic

11 (22)

7 (63.6)

8 (72.72)

3 (27.27)

Caverno-oclusive

30 (60)

20 (66.6)

21 (70)

9 (30)

Arteriogenic+

Caverno- oclusive

9 (18)

5 (55.55)

6 (66.66)

3 (33.33)

           

Figure 1

Disclosure:

Work supported by industry: no.

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