EFFECT OF DAILY PDE5i USE ON TRIMIX INTRACORPOREAL INJECTION DOSAGE IN MEN WITH SEXUAL DYSFUNCTION FOLLOWING RADICAL PROSTATECTOMY

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https://academic.oup.com/jsm/article/21/Supplement_6/qdae161.019/7916940?login=false&utm_source=etoc&utm_campaign=jsm&utm_medium=email

Abstract

Introduction

Trimix intracavernosal injections (ICI) is believed to be a reliable treatment option for men who underwent radical prostatectomy resulting in satisfactory erections suitable for penetration. Nonetheless, higher doses of trimix ICI may illicit penile pain and are associated with a higher incidence of priapism.


Objective

The aim of this study was to explore whether daily PDE5i use may potentiate the effect of ICI allowing patients to achieve the desired response with lower Trimix ICI dosage.


Methods

We conducted a retrospective analysis of our institutional database to identify patients experiencing erectile dysfunction due to prostate cancer treatment. Data about 155 Patients who underwent Ultrasound Penile Doppler (US PD), utilized Trimix ICI with/without daily PDE5i between 2020 & 2022, and had a follow-up for at least 1 year were included. Correlations were made between demographic data, ultrasound penile doppler readings, and changes in Trimix ICI dosage. Patients were divided into 2 groups based on their PDE5i usage (group 1: No PDE5i intake n = 84; group 2: PDE5i intake n = 71) and chi-squared test was used to explore the effect of PDE5i on changes in ICI dosage.


Results

Overall, 20.6% of the patients had diabetes, 52.3% had hypertension, 76.2% had prostatectomy, 29% had a previous history of radiation treatment, 18.7% had a history of androgen deprivation therapy, and 18.1% reported using B blockers. Additionally, 57% of the patients utilized vacuum erection devices. No significant correlation was observed between changes in ICI dosage and the parameters listed in Table 1. Significantly higher percentage of patients from group 1 reported an increase in Trimix ICI dose during follow-up compared with group 2 (59.1% vs 40.9%, p = 0.04). None of the 155 patients experienced priapism during the follow-up period.


Conclusions

While additional comprehensive follow-up is required, these preliminary results suggest that consistent daily use of PDE5i is not only safe but also has the potential to diminish the requirement for increased doses of Trimix ICI within this specific group of patients.