Presentation Authors: Ana Paula Bispo*, Scheila Nascimento, Roberto Soler, Sao Paulo, Brazil
Introduction: To evaluate the effect of functional electrostimulation (FES) as a penile rehabilitation procedure on the erectile function (EF) of patients following nerve sparing radical prostatectomy (NSRP).
Methods: This was a prospective, blind, randomized, sham-controlled trial. The study included men â‰¤ 70 yr undergoing radical prostatectomy with bilateral preservation of the neurovascular bundle, with previous unassisted normal EF (International Index of Erectile Function, Erectile Function domain [IIEF-EF] score â‰¥ 26); total PSA < 10 ng/mL and Gleason score â‰¤ 7. Patients were randomly assigned, in a 1:1 ratio, to undergo FES or sham procedure. Penile rehabilitation was performed for 6 months, twice a week, during 30 minutes. Patients were evaluated at 1, 3, 6, 9 and 12 months after the start of the procedures. The primary endpoint was proportion of patients with IIEF-EF score â‰¥ 22 after 12 months of the start of treatment. Secondary endpoints included rate of positive responses to Sexual Encounter Profile (SEP) questions 2 and 3 and to Global Assessment Question (GAQ) questions 1 and 2.
Results: Twenty and three patients were randomized to FES and 26 to sham. After 12 months of the start of the study procedures 52.2% and 19.2% of patients reached IIEF-EF score â‰¥ 22 in FES and sham groups, respectively (p = 0.016). This effect was also observed in other endpoints (table 1). A significantly higher proportion of patients in FES group compared to sham group had positive responses to SEP2 and GAQ1 from the 6th month to the end of the study. There was numerical, but no statistical, difference in the rate of SEP3 and GAQ2 positive responses between the groups. No adverse events related to FES were reported by patients.
Conclusions: Functional electrostimulation was efficacious and safe as a penile rehabilitation procedure in improving recovery of unassisted EF in patients undergoing NSRP. The effect of FES was maintained after cessation of active therapy.
Source of Funding: Coordination for the Improvement of Higher Education Personnel (CAPES)