Impotence following radical cystoprostatectomy prevention and treatment

ABSTRACT

Over the past three years [1991 - 1994], 33 sexually active male patients with invasive bladder cancer were selected for nerve sparing radical cystoprostatectomy aiming at the preservation of potency. Five patients were excluded due to postoperative mortality or early recurrence. Among the remaining 28 patients, potency was successfully preserved in 29%. Intracorporal injection [ICI] of vasoactive agents was tried for the remaining patients in whom the nerve sparing technique failed to preserve potency. The pharmacological manipulation was successful in inducing adequate erection in 25% of injected patients. Patients with inadequate or no response to ICI [15 patients] were offered the option of a penile prosthetic implant. Three different types of prostheses were used The flexible silastic [4 patients], the malleable silastic, AMS 600 [2 patients] and the hydroflex self-contained inflatable prosthesis [one patient]. Eight patients refused the prosthetic implant