Partner Erectile Dysfunction Research Articles

The Experiences of Female Partners of Patients With Erectile Dysfunction Due to Prostate Cancer Treatment in China: A Qualitative Exploration.

Because of sociocultural factors, Chinese female partners of patients with prostate cancer (PC) may have perspectives and needs that differ from the more published reports of female partners living in Western cultures. The aim of this study was to explore the experiences of female partners of patients with PC experiencing erectile dysfunction in China. In this interpretive descriptive design, qualitative data were collected from semistructured telephone interviews with purposively sampled participants from the urology outpatient unit in a hospital in South China. The interviews were audiotaped, transcribed, and analyzed using a constant comparison approach. Three themes emerged from the analysis of the participants' narratives: (a) acceptance of ceasing sex; (b) preserving intimacy through caregiving; and (c) the need for sexual health-related information. Participants in this study reported that their own sexuality and intimacy were affected by their partner's erectile dysfunction, but they adjusted to sexuality and intimacy changes through their caregiving of their husbands owing to Chinese traditional perspectives on women's obligations. They also reported having unmet informational needs in improving sexual well-being for the sake of their partners, lending further support to the likely benefit of couple-based educational interventions addressing sexual wellness in dyads affected by PC and erectile dysfunction. The present study findings highlighted the need for more research attention to the support of Chinese female partners of patients with PC regarding sexual and intimate topics.

Association between the international index of erectile function-15 and female sexual function index in Chinese infertile couples.

Infertility has a detrimental impact on the sexual function of involuntarily childless couples. However, the effect of male sexual function on female partner's sexual function in infertile couples remains unknown. In order to explore the association between these couples' sexual function, 324 consecutive couples with infertility and 326 female-age-matched fertile couples were enrolled in this study. The female sexual function index (FSFI) and sexual history were evaluated in female partners. In addition to the international index of erectile function-15 (IIEF-15) and sexual history, self-reported intravaginal ejaculation latency time was evaluated in male partners. The demographics and depression status of couples were also recorded. We observed a higher occurrence of female sexual dysfunction (FSD) in infertile females than in fertile females (58.6% vs. 50.3%, p=0.033). FSD was associated with a number of risk variables, including partner's erectile dysfunction (ED), depression and sexual frequency. The overall FSFI score was positively associated with the IIEF-15 score (r=0.347, p<0.001). Besides, six FSFI domains were positively correlated with five IIEF-15 domains (p<0.05). In conclusion, it is critical to assess and address FSD as well as the sexual problems in male partners in infertile couples.

Is Female Wellness Affected When Men Blame Them for Erectile Dysfunction?

IntroductionSeveral studies have investigated the association between erectile dysfunction (ED), its treatment, and female sexual dysfunction, but the impact of males blaming their female partners for their ED remains unknown.AimsTo investigate whether women who are blamed by their male partners for their ED experience worse overall sexual function and satisfaction.MethodsWe performed a global, cross-sectional web-based survey to investigate female perceptions of ED. We distributed the 30-item survey via email, Reddit, Amazon Mechanical Turk, and Facebook. Women 18 years of age or older were eligible to participate and answered questions based on a 5-point Likert scale. Women were grouped by ages 18-29, 30-39, and 40 and older.Main Outcome MeasuresThe survey collected data that included general demographics and questions regarding experiencing male blame for ED and its relationship with each subject's sexual health and wellness.ResultsA total of 13,617 females participated in the survey. Of the women surveyed, 79% have experienced their partner losing their erection during sexual activity and approximately 1 out of 7 women (14.7%) had experienced being blamed by their partner for loss of their erection. Women who were blamed for their partner's ED were more likely to end the sexual encounter, were less sexually satisfied, and were more likely to end relationships due to their partner's ED.ConclusionApproximately 1 out of 7 women have experienced male blame for their partner's ED which is associated with negative impacts on female mental health, sexual satisfaction and the success of the overall partnership. Because of its widespread impact on female wellness, male blame should be considered during evaluation of female sexual history and men must be educated on the significant impact their reactions during intimacy have on their female partners and their relationships as a whole. Dubin JM, Wyant WA, Balaji NC, et al. Is Female Wellness Affected When Men Blame Them for Erectile Dysfunction?. Sex Med 2021;9:100352.

A Clinical Reference Guide on Sexual Devices for Obstetrician-Gynecologists.

In the United States, more than half of all women have used a vibrator, nearly one third of women have used a dildo, and more than three quarters of women who have sex with women have used a vibrator. Sexual devices can be used by patients with decreased libido, anorgasmia, conditions inhibiting vaginal penetration, partner erectile dysfunction, and motor or sensory disabilities. Basic knowledge of sexual devices can help obstetrician-gynecologists counsel patients about device safety, sharing, cleaning, disinfection, and material selection. Common sexual devices include vibrators, penetrative devices, anal-specific devices, and air pulsation devices. Collision dyspareunia aids can assist patients who experience difficulty with deep penetration owing to pain and structural limitations. Although rare, the most common risks of sexual devices are traumatic injury and infection. Barrier use over sexual devices and proper disinfection can help reduce, but not eliminate, the risk of transmission of common viral and bacterial sexually transmitted infections. Sexual devices made of nonporous materials are the safest and easiest to clean and disinfect. Porous materials should be avoided given inability to disinfect and risk of material breakdown. Sexual devices can benefit specific patient populations, including women who are pregnant or postpartum, those with disorders of sexual function or pelvic floor, menopausal patients, cancer patients undergoing treatment, and women with disability and chronic illness.

Sexuality in postmenopausal women in sub-Saharan Africa: example from Senegal

IntroductionEn Afrique, la vie sexuelle après la ménopause reste un domaine mal exploré du fait de son caractère tabou. L'objectif de cette étude était d'apprécier la qualité de la sexualité du couple au cours de la ménopause.MethodesIl s'agissait d'une une enquête transversale concernant un échantillon représentatif de 320 femmes ménopausées. Les critères d'inclusion étaient la ménopause naturelle. N'étaient pas incluses de l'étude les patientes ayant fait l'objet d'une ménopause précoce ou iatrogène. La fiche d'enquête était divisée en 4 chapitres : les caractéristiques socio-culturelles de la femme, les données cliniques, les données psycho-sexuelles et les données thérapeutiques. Nous avons utilisé la comparaison des proportions et le test du Chi 2 avec un seuil de signification inférieur à 0,05.ResultatsL'âge moyen des femmes était de 60 ans. L'âge moyen de survenue de la ménopause était de 48 ans et l'ancienneté de la ménopause était de 11,3 ans. Aucune femme de notre étude n'était épargnée par les manifestations du syndrome climatérique. Les bouffées de chaleur étaient présentes dans 85,9%, la sècheresse vaginale dans 62,8% et les troubles urinaires dans 52,5%. Seules les femmes mariées déclaraient avoir des rapports sexuels avec leurs conjoints (62,1%). Ces rapports sexuels étaient occasionnels dans 68,9% des cas alors que 18,1% des femmes n'avaient plus d'activité sexuelle. La diminution de l'activité sexuelle était due aux troubles de l'érection du conjoint (62% des couples) et au manque de désir sexuel (83,5% des femmes). Une absence d'excitation sexuelle et d'orgasme étaient également retrouvée respectivement dans 92% et 100%. Cependant, 93,5 % des femmes mariées jugeaient supportable leur vécu.ConclusionLe statut marital, la dyspareunie, la sècheresse vaginale et les troubles érectiles du conjoint ont un impact réel sur la sexualité de la femme ménopausée au Sénégal.

Women's Sexual Health and Aging.

Older women are often sexually active, but physicians caring for older women rarely address sexual concerns. Although women's desire for sex declines with age, a majority of older women rate sex as having importance in their lives. Women identify emotional intimacy as an important reason for engaging in sexual relationships. Women are less likely than men to have an available spousal or intimate partner and more likely to have a partner with sexual difficulties of their own. Up to half of sexually active older women report a distressing sexual problem, with low desire and problems related to genitourinary syndrome (vulvovaginal atrophy) being most common. Difficulty with orgasm in older women is often associated with a partner's erectile dysfunction. Sexually transmitted infections (STIs) are increasingly prevalent in older women. A minority of older women report discussing sexual issues with a physician. Most commonly, the patient initiates discussions. Physicians should ask regularly and proactively about sexual activity and function. Important interventions include offering practical advice to common chronic medical conditions and sexual problems that confront older women; treating vulvovaginal atrophy; and providing STI screening, prevention strategies, and treatment when appropriate.

Which are the male factors associated with female sexual dysfunction (FSD)?

It has been generally assumed that partner's erectile dysfunction, premature, and delayed ejaculation play a significant role in determining female sexual dysfunction (FSD). This study aimed to evaluate the role of the male partner's sexual function, as perceived by women, in determining FSD. A consecutive series of 156 heterosexual women consulting our clinic for FSD was retrospectively studied. All patients underwent a structured interview and completed the Female Sexual Function Index (FSFI). FSFI total score decreased as a function of partner's age, conflicts within the couple, relationship without cohabitation and the habit of engaging in intercourse to please the partner; FSFI total score increased as a function of frequency of intercourse, attempts to conceive and fertility-focused intercourse. FSFI total score showed a negative, stepwise correlation with partner's perceived hypoactive sexual desire (HSD) (r=-0.327; p<0.0001), whereas no significant correlation was found between FSFI and erectile dysfunction, premature and delayed ejaculation. In an age-adjusted model, partner's HSD was negatively related to FSFI total score (Wald=9.196, p=0.002), arousal (Wald=7.893, p=0.005), lubrication (Wald=5.042, p=0.025), orgasm (Wald=9.293, p=0.002), satisfaction (Wald=12.764, p<0.0001), and pain (Wald=6.492, p=0.011) domains. Partner's HSD was also significantly associated with somatized anxiety, low frequency of intercourse, low partner's care for the patient's sexual pleasure, and with a higher frequency of masturbation, even after adjusting for age. In patients not reporting any reduction in libido, FSFI total score was significantly lower when their partner's libido was low (p=0.041); the correlation disappeared if the patient also experienced HSD. In conclusion, the presence of erectile dysfunction, premature, and delayed ejaculation of the partner may not act as a primary contributing factor to FSD, as determined by FSFI scores; conversely, women's sexuality seems to be mostly impaired by the perceived reduction in their partner's sexual interest.

Which are the male factors associated with female sexual dysfunction (FSD)?

It has been generally assumed that partner's erectile dysfunction, premature, and delayed ejaculation play a significant role in determining female sexual dysfunction (FSD). This study aimed to evaluate the role of the male partner's sexual function, as perceived by women, in determining FSD. A consecutive series of 156 heterosexual women consulting our clinic for FSD was retrospectively studied. All patients underwent a structured interview and completed the Female Sexual Function Index (FSFI). FSFI total score decreased as a function of partner's age, conflicts within the couple, relationship without cohabitation and the habit of engaging in intercourse to please the partner; FSFI total score increased as a function of frequency of intercourse, attempts to conceive and fertility-focused intercourse. FSFI total score showed a negative, stepwise correlation with partner's perceived hypoactive sexual desire (HSD) (r = -0.327; p < 0.0001), whereas no significant correlation was found between FSFI and erectile dysfunction, premature and delayed ejaculation. In an age-adjusted model, partner's HSD was negatively related to FSFI total score (Wald = 9.196, p = 0.002), arousal (Wald = 7.893, p = 0.005), lubrication (Wald = 5.042, p = 0.025), orgasm (Wald = 9.293, p = 0.002), satisfaction (Wald = 12.764, p < 0.0001), and pain (Wald = 6.492, p = 0.011) domains. Partner's HSD was also significantly associated with somatized anxiety, low frequency of intercourse, low partner's care for the patient's sexual pleasure, and with a higher frequency of masturbation, even after adjusting for age. In patients not reporting any reduction in libido, FSFI total score was significantly lower when their partner's libido was low (p = 0.041); the correlation disappeared if the patient also experienced HSD. In conclusion, the presence of erectile dysfunction, premature, and delayed ejaculation of the partner may not act as a primary contributing factor to FSD, as determined by FSFI scores; conversely, women's sexuality seems to be mostly impaired by the perceived reduction in their partner's sexual interest.

Application of the 10-item Cervantes Scale among mid-aged Ecuadorian women for the assessment of menopausal symptoms

BackgroundThe majority of instruments used to evaluate menopausal symptoms are long and complex. In this sense, more simple tests are being designed to rapidly obtain a snapshot of the global clinical picture. ObjectiveTo assess menopausal symptoms in mid-aged women using the short 10 item version of the original menopause Cervantes Scale (CS-10). MethodThis was a cross sectional study in which a total of 451 Ecuadorian women (40–59 years) were surveyed with the CS-10 and a general socio-demographic questionnaire containing personal and partner data. ResultsMedian age of the whole sample was 48 years. A 41.2% were postmenopausal, 44.3% abdominally obese (waist circumference >88cm), 6% diabetic, 16.9% hypertense, 11.5% smoked, 6.9% currently used hormone therapy, 9.5% phytoestrogens and 6.7% psychotropic drugs. For the entire sample, median [interquartile range] CS-10 global scores were 10.0 [9.5], and for pre-, peri- and postmenopausal women: 5.0 [7.0], 11.0 [9.0] and 13.5 [8.0], respectively. The CS-10 displayed good internal consistency (Cronbach's alpha 0.87). According to the CS-10, the three most prevalent menopausal symptoms were: muscle and joint pains (88.5%), hot flushes (77.6%) and skin dryness (71.4%). Multiple linear regression analysis found that postmenopausal status, parity, unhealthy perceived status, psychotropic drug use, partner erectile dysfunction, lower coital frequency and living at high altitude were related to higher CS-10 global scores. ConclusionIn this mid-aged Ecuadorian female sample severity of menopausal symptoms, as determined by the CS-10, were related to environmental and female/partner personal and socio-demographical aspects.

Women's Sexuality after Cancer: A Qualitative Analysis of Sexual Changes and Renegotiation

Changes to sexual wellbeing and intimacy after cancer were examined through interviews with 41 women; 23 women with cancer and 18 partners of a person with cancer. Thematic analysis identified 2 core themes: 1) Changes to sexuality after cancer: loss of sexual desire, sexual pain, concerns about body image, tiredness, and partner erectile dysfunction; Coital failure equals loss of sex and intimacy; and a counter-narrative in which sexuality is the same after cancer, more commonly reported by non-heterosexual women. 2) Renegotiating Sex: resisting the coital imperative and embracing intimacy. Implications of these findings for therapeutic interventions are discussed.

Sexual activity of middle‐aged women coupled with a male partner in Japan

To assess the sexual activity of women with male partners in Japan. An original web-based questionnaire was conducted. A total of 2593 women in five age groups (20s, 30s, 40s, 50s, and 60s or older) were randomly invited to participate. Of the 1077 (41.5%) respondents, data for 883 women with partners were evaluated. Age and 15 items related to sexual activity and social background were analyzed. Women who stated that they neither had sexual activity with a partner nor had frustration with a partner's erectile dysfunction (ED) were defined as low sexuality (LS) subjects. Some subjects in the LS group were psychologically serious cases who did not feel the importance of a sexual relationship with their partner. These subjects were selected and defined as high-risk LS (HLS) subjects. Of the participants, 36.6% (n = 323) stated that they did not have sexual activity with their partner, and 30.7% (n = 271) and 21.7% (n = 192) were categorized as LS and HLS subjects, respectively. The percentage of HLS subjects increased significantly with age: 2.0%, 5.6%, 18.6%, 36.1% and 41.8% in the 20s, 30s, 40s, 50s, and 60s or older age groups, respectively. Age and unemployment status were independent predictors of HLS behavior. A high proportion of Japanese middle-aged women with a male partner have low sexual activity.

Erectile Dysfunction (ED) is a Shared Sexual Concern of Couples II: Association of Female Partner Characteristics with Male Partner ED Treatment Seeking and Phosphodiesterase Type 5 Inhibitor Utilization

Erectile dysfunction (ED) is a prevalent condition that impacts on both patients and their female partners. ED may therefore be regarded as a shared sexual concern for couples. The current analysis of the Female Experience of Men's Attitudes to Life Events and Sexuality (FEMALES) study data addresses women's perceptions, beliefs, and attitudes concerning their partner's ED, and whether these are associated with the likelihood of the male partner seeking medical advice and utilizing phosphodiesterase type 5 inhibitors. The current research sought to explore the association of female partners' perceptions of male partners' ED and male partners' medical consultation and treatment seeking for ED. Questionnaires were sent to partners of men who participated in the Men's Attitudes to Life Events and Sexuality (MALES) 2004 study, and who consented to their partner's involvement. A modified version of the questionnaire used in the MALES study was developed for the FEMALES study, reflecting the female partner's perspective. A 65-item questionnaire assessing women's perceptions, beliefs, and attitudes regarding various aspects of ED. Women's perceptions of the nature and causes of their partner's ED were significantly associated with men's treatment seeking and utilization. Significant associations were observed between women's level of satisfaction with the relationship before ED onset; perceptions of the impact of ED on quality of life; desire to deal with ED; attitudes to ED treatment; and the treatment-seeking behavior of the male partner. Multivariate regression analyses identified a mixture of female and male partner perceptions and attitudes that uniquely accounted for >30% of the variance in men's ED treatment-seeking behavior and treatment utilization. This study illustrates the importance of the female partner's attitudes to ED in men's ED treatment-seeking behavior. These findings strongly support the potential benefits of partner integration into ED consultation and treatment strategies.

ORIGINAL RESEARCH—COUPLES' SEXUAL DYSFUNCTIONS: Erectile Dysfunction (ED) is a Shared Sexual Concern of Couples I: Couple Conceptions of ED

ABSTRACT Introduction Erectile dysfunction (ED) may be regarded as a shared sexual concern with a significant negative impact on both patients and their partners. Aim The current research sought to explore the degree of concordance or divergence of couple members’ perceptions of the specific functional impairments characterizing the man’s ED, and the concordance or discordance of their attitudes, beliefs and experiences about the male partner’s erectile difficulty. Methods Questionnaires were sent to partners of men who participated in the Men’s Attitudes to Life Events and Sexuality (MALES) 2004 study, who consented to their partner’s involvement. A modified version of the questionnaire used in the MALES study was employed, adapted to reflect the female partner’s perspective. Questionnaire responses were analyzed in relation to responses provided by male study participants. Main Outcome Measure A 65-item questionnaire assessing women’s perceptions, beliefs, and attitudes regarding aspects of ED. Results High levels of concordance between couple members were observed across almost all items. Women’s perceptions of both the specific functional impairments characterizing their partner’s ED and the frequency of the partner’s erection difficulty were strongly associated with assessments the men themselves had made. Significant associations were also observed between couple members’ responses relating to their beliefs about the causes of ED, effects of ED on the relationship, communication about ED, finding a solution to ED, and attitudes toward medication. A number of specific male–female discordant perceptions and attitudes were also identified. Conclusions Findings of this study demonstrate a high degree of concordance in couple members’ perceptions of the male partner’s ED, and in their attitudes and beliefs about ED. Specific instances of discordance between couple members may contribute to treatment avoidance or couple conflict.

Couple perceptions and attitudes towards erectile dysfunction: findings of the FEMALES study

Objectives Erectile dysfunction (ED) impacts greatly on men and their female partners. The Female Experience of Men's Attitudes to Life Events and Sexuality (FEMALES) study assessed levels of concordance or divergence among couple members’perceptions of the specific functional impairments characterising the male partner's ED, and their attitudes, beliefs and experiences relating to ED. Design and method Questionnaires were sent to partners of men with ED who participated in the Men's Attitudes to Life Events and Sexuality (MALES) 2004 study, and who consented to their partner's involvement. FEMALES questionnaire responses were analysed in relation to responses to equivalent questions provided by male study participants. Results Women's perceptions of the specific functional impairments characterising their partner's ED and the frequency of his erection difficulty were highly associated with assessments by the man. Significant associations were observed between couple members’responses regarding their attitudes, beliefs and experiences relating to ED. A number of sex-specific findings were highlighted, where couple members held divergent views on the effect of ED on the couples’everyday and sexual life. Conclusions A high degree of concordance in couple member's perceptions of the male partner's ED, and their attitudes and beliefs about ED was observed. However, a number of differences between males’and females’perceptions and attitudes were evident. Instances of discordance may be significant for the couple, and may contribute to treatment avoidance or conflict.

T02-O-07 Do female partners’ attitudes affect treatment-seeking behaviour and treatment utilisation in men with erectile dysfunction? The Females study

Objectives Erectile dysfunction (ED) represents a shared sexual concern for couples. Despite the availability of highly effective therapies for ED, many men do not seek or utilize treatment. The Female Experience of Men's Attitudes to Life Events and Sexuality (FEMALES) study explored women's perceptions, beliefs and attitudes regarding their partner's ED, and investigated whether these factors are associated with the likelihood of men seeking medical advice and using phosphodiesterase type-5 (PDE-5) inhibitor treatment. Design and method Questionnaires were sent to partners of men with ED who participated in the Men's Attitudes to Life Events and Sexuality (MALES) 2004 study, and who consented to their partner's involvement. FEMALES questionnaire responses were analysed in relation to responses to equivalent questions provided by male study participants. Results There were significant associations between the woman's belief that her partner's ED was permanent and men's treatment-seeking behaviour (Chi-square=86.43; p Conclusions This study highlights the importance of the female partner's attitudes to ED in the treatment-seeking behaviour and PDE-5 inhibitor utilisation of the male partner.

Sexual Experience of Female Partners of Men with Erectile Dysfunction: The Female Experience of Men's Attitudes to Life Events and Sexuality (FEMALES) Study

Much research has explored the experience of erectile dysfunction (ED) among men with ED, but far less attention has been paid to the perceptions and sexual experiences of the female partners of men with ED. The objective of this study was to characterize the attitudes, beliefs, and sexual experience of female partners of men with erectile difficulties. Female partners of men with ED who had participated in the Men's Attitudes to Life Events and Sexuality (MALES) study were recruited for this research via mail or Internet, after their male partners consented to this contact. Female partners of men with ED (N = 293) responded to questionnaire measures assessing their frequency of sexual activity and the nature of their sexual experience, both before and after the development of their partner's ED, and in relation to their partner's use of phosphodiesterase type 5 (PDE5) inhibitors. Women reported engaging in sexual activity significantly less frequently after their partner developed ED in comparison with before (P < 0.001). Moreover, significantly fewer women experienced sexual desire, arousal, or orgasm "almost always" or "most times," and significantly fewer women reported satisfaction with their sexual relationship after their partner developed ED, compared with before (P < 0.001). Decreases in female sexual satisfaction and frequency of orgasm were significantly related to the male partner's self-reported severity of ED (P < 0.01). The proportion of women who experienced sexual desire, arousal, and orgasm "almost always" or "most times" was significantly higher in the group whose partners were currently using a PDE5 inhibitor (P < 0.05). Erectile dysfunction has significant adverse effects on the female partner's sexual experience. Women with partners who were currently using PDE5 inhibitors had a more satisfying sexual experience than those whose partners did not use a PDE5 inhibitor.

Partner responses to sildenafil citrate (Viagra) treatment of erectile dysfunction

Objectives To evaluate in a pooled analysis of multiple studies the perceptions of effectiveness and overall treatment satisfaction in the partners of patients who received sildenafil citrate for treatment of erectile dysfunction. Partner satisfaction with treatment of erectile dysfunction can have a substantial impact on the continuation of therapy. Methods Each partner rated the man's erectile function and her own intercourse satisfaction by responding to three appropriately modified questions from the International Index of Erectile Function, assessing frequency of erections, ability to maintain erections, and satisfaction of intercourse in 14 double-blind placebo-controlled trials of sildenafil. Partner satisfaction with sildenafil treatment was evaluated using the Erectile Dysfunction Inventory of Treatment Satisfaction partner questionnaire in six of these trials. Results Of 3634 patients enrolled in these 14 trials, the partners of 930 patients agreed to participate. The partners reported that men receiving sildenafil had significantly greater erection frequency and ability to maintain erections than men receiving placebo, irrespective of patient age. Partners of sildenafil-treated men also had more frequent intercourse satisfaction compared with partners of placebo-treated men ( P <0.0001). In both treatment groups, the partner and patient responses correlated highly ( P <0.0001). The correlation between patient and partner Erectile Dysfunction Inventory of Treatment Satisfaction index scores was 0.80 for placebo and 0.86 for sildenafil ( P <0.0001). Conclusions Partner evaluations corroborated the patient assessments, with both indicating that treatment with sildenafil resulted in statistically significant improvement in erectile function and suggesting that partners were satisfied with sildenafil treatment for erectile dysfunction.

MECHANICAL RELIABILITY AND SAFETY OF, AND PATIENT SATISFACTION WITH THE AMBICOR INFLATABLE PENILE PROSTHESIS: RESULTS OF A 2 CENTER STUDY

We reviewed the experience with the 2-piece Ambicor penile prosthesis (American Medical Systems, Minnetonka, Minnesota) at 2 medical centers to investigate its mechanical reliability and complication rates as well as patient and partner satisfaction with the device. From 1995 through 1999, 131 men underwent implantation of an Ambicor penile prosthesis at 2 medical centers. We performed a 3-part study consisting of a retrospective clinical record review, mailed patient and partner questionnaire, and mailed modified patient and partner Erectile Dysfunction Inventory of Treatment Satisfaction questionnaire. Mean followup was 43.4 months (range 12 to 73). All 131 men had a history consistent with an organic etiology of erectile dysfunction, including vascular disease in 62%, radical retropubic prostatectomy in 17%, Peyronie's disease in 15%, neophallus construction in 4% and radical pelvic surgery in 2%. Mean patient age was 56.8 years (range 22 to 76) at implantation. Overall there were complications in 10 cases (7.6%), including infection, hematoma and mechanical failure in 6 (4.6%), 1 (0.7%) and 3 (2.3%), respectively. A total of 112 men (85%) and 91 partners completed the questionnaire. All patient respondents still had an Ambicor prosthesis implanted and 96.4% had erection suitable for coitus. Overall patient and partner satisfaction was 96.4% and 91.2%, respectively. Of the respondents 92.9% of patients and 90.1% of partners would recommend the device to others. Of the 85 men (65%) and 46 partners who completed the modified Erectile Dysfunction Inventory of Treatment Satisfaction survey 90.6% and 82.6%, respectively, were satisfied or very satisfied overall with the penile prosthesis. The Ambicor penile prosthesis is associated with a low complication rate and reliable mechanical function. High satisfaction was reported by patients and partners.

Bilateral nerve graft during radical retropubic prostatectomy: 1-year followup.

With the interposition of a sural nerve graft to replace resected cavernous nerves at radical retropubic prostatectomy, we have previously reported the return of effective erectile function. We determine the efficacy of this procedure in a series of men with at least 1-year followup. A total of 12 potent men (mean age plus or minus standard deviation 57 +/- 6 years) with clinically localized prostate cancer underwent radical retropubic prostatectomy, with deliberate wide bilateral neurovascular bundle resection and placement of bilateral nerve grafts. A series of patient and partner erectile dysfunction questionnaires, and patient interviews were performed at 3, 6, 12 and 18 months postoperatively. Only results for those men with a followup of 12 months or greater (mean 16 +/- 4) are presented. A control group of 12 men who had undergone bilateral nerve resection but declined nerve graft placement, was also followed. Of the 12 men 4 (33%) had spontaneous medically unassisted erections sufficient for sexual intercourse with vaginal penetration. An additional 5 (42%) men describe "40 to 60%" spontaneous erections, with fullness, no rigidity and not able to penetrate. Overall, 9 (75%) men had return of erectile activity. No demonstrable erections occurred before 5 months postoperatively. The greatest return of function was observed at 14 to 18 months after surgery. This surgical technique has minimal morbidity and represents a significant advance in prostate cancer surgery in men requiring bilateral nerve resection. Our study clearly demonstrates recovery of erectile function in men who underwent bilateral nerve graft placement during radical retropubic prostatectomy when both cavernous nerves were deliberately resected.

BILATERAL NERVE GRAFT DURING RADICAL RETROPUBIC PROSTATECTOMY: 1-YEAR FOLLOWUP

Purpose: With the interposition of a sural nerve graft to replace resected cavernous nerves at radical retropubic prostatectomy, we have previously reported the return of effective erectile function. We determine the efficacy of this procedure in a series of men with at least 1-year followup.Materials and Methods: A total of 12 potent men (mean age plus or minus standard deviation 57 ± 6 years) with clinically localized prostate cancer underwent radical retropubic prostatectomy, with deliberate wide bilateral neurovascular bundle resection and placement of bilateral nerve grafts. A series of patient and partner erectile dysfunction questionnaires, and patient interviews were performed at 3, 6, 12 and 18 months postoperatively. Only results for those men with a followup of 12 months or greater (mean 16 ± 4) are presented. A control group of 12 men who had undergone bilateral nerve resection but declined nerve graft placement, was also followed.Results: Of the 12 men 4 (33%) had spontaneous medically unassi...