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Volume 21, Issue 6 (November 2019) 21, 582–586; 10.4103/aja.aja_50_19

Adding a vacuum erection device to regular use of Tadalafil improves penile rehabilitation after posterior urethroplasty

Dong-Liang Zhang1, Zhong Chen1, Fei-Xiang Wang2, Jiong Zhang1, Hong Xie1, Ze-Yu Wang1, Yu-Bo Gu1, Qiang Fu1, Lu-Jie Song1

1 Department of Urology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Oriental Institute for Urologic Reconstruction, Shanghai 200233, China
2 Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine, Shanghai 200233, China

Correspondence: Dr. LJ Song (ljsong@sjtu.edu.cn) or Dr. Q Fu (jamesqfu@aliyun.com)



This study aimed to evaluate whether adding a vacuum erection device (VED) to regular use of Tadalafil could achieve better penile rehabilitation following posterior urethroplasty for pelvic fracture-related urethral injury (PFUI). Altogether, 78 PFUI patients with erectile dysfunction (ED) after primary posterior urethroplasty were enrolled and divided into two treatment groups: VED combined with Tadalafil (Group 1, n = 36) and Tadalafil only (Group 2, n = 42). Changes in penile length, testosterone level, International Index of Erectile Function-5 (IIEF-5) questionnaire, Quality of Erection Questionnaire (QEQ), and nocturnal penile tumescence (NPT) testing were used to assess erectile function before and after 6 months of ED treatment. Results showed that the addition of VED to regular use of Tadalafil preserved more penile length statistically (0.4 ± 0.9 vs −0.8 ± 0.7 cm, P < 0.01). IIEF-5 score and QEQ score in Group 1 were higher than Group 2 (both P < 0.05). After treatment, 21/36 (58.3%) Group 1 patients and 19/42 (45.2%) Group 2 patients could complete vaginal penetration. Group 1 patients also had markedly improved testosterone levels (P = 0.01). Unexpectedly, there was no significant difference in NPT testing between two therapies. For PFUI patients with ED after posterior urethroplasty, the addition of VED to regular use of Tadalafil could significantly improve their conditions – improving erection and increasing penile length – thus increasing patient satisfaction and confidence in penile rehabilitation.

Keywords: pelvic fracture urethral injury; penile rehabilitation; posterior urethroplasty; Tadalafil; vacuum erection devices

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