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Vacuum erection device for erectile function rehabilitation after radical prostatectomy: which is the correct schedule? Results from a systematic, scoping review

International Journal of Impotence Research (2023)Cite this article

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Abstract

Vacuum erection device (VED), for its capacity to improve the peak flow and elasticity of cavernous arteries, is a well-known tool to improve recovery of erectile function (EF) after radical prostatectomy. Aim of this study is to compare the different therapeutic schemes proposed in literature to find the most effective timing for VED treatment and to evaluate its efficacy alone or associated with phosphodiesterase 5 inhibitors (PDE5i). We performed a systematic review of Literature in October 2022 using MEDLINE, EMBASE, and Cochrane Central Controlled Register of Trials to retrieve all articles dealing with EF rehabilitation after radical prostatectomy (excluding non-English papers, reviews, or meeting abstracts). Patients were divided among those receiving VED alone or combined with other treatments. Study outcomes were compared dividing them between those with follow-up shorter or longer than 12 months. Sixteen papers were included according to selection criteria. Among them, seven were randomized-controlled trials, five were prospective observational studies and four were retrospective. VED alone was evaluated in eight articles, while the remaining papers evaluated the combination of VED with PDE5i. Regarding VED therapeutic protocol, 7/16 studies used it daily. Rehabilitation protocol lasted less than 1 year in 4 studies, up to 12 months in 6 studies and more than 1 year in 6 studies. All the studies show improvement in International Index of Erectile Function Questionnaire (IIEF-5), conservation of penile length and satisfactory intercourses when compared to controls. VED results appear to increase when patients were addressed to VED-dedicated programs to enhance their compliance with the device.

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Fig. 1

Data availability

The full text of all articles cited in this review have been read and assessed by the Authors. Data are available through the Reference section.

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Author information

Authors and Affiliations

  1. Department of Urology, San Giuseppe Hospital, IRCCS Multimedica, Milano, Italy

    Giacomo Maria Pirola, Angelo Naselli & Andrea Guarneri

  2. Maternal Infant and Urologic Sciences, Policlinico Umberto I Hospital, “Sapienza” University of Rome, Rome, Italy

    Martina Maggi

  3. Department of Urology, Usl Toscana Sud Est, San Donato Hospital, Arezzo, Italy

    Marilena Gubbiotti

  4. Department of Urology, A.O.U.I. Verona University, Verona, Italy

    Emanuele Rubilotta

  5. Department of Surgery, S.H. Ho Urology Center, The Chinese University of Hong Kong, Hong Kong, China

    Teoh Jeremy Yuen‑Chun

  6. Department of Urology, Ng Teng Fong General Hospital, National University Health System, Singapore, Singapore

    Vineet Gauhar

  7. Department of Urology, University Hospital “Ospedali Riuniti” and Polytechnic University of Marche Region, Ancona, Italy

    Daniele Castellani

Authors
  1. Giacomo Maria Pirola
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  2. Angelo Naselli
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  3. Martina Maggi
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  4. Marilena Gubbiotti
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  5. Emanuele Rubilotta
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  6. Teoh Jeremy Yuen‑Chun
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  7. Andrea Guarneri
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  8. Vineet Gauhar
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  9. Daniele Castellani
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Contributions

Study design: GMP and AN; Article screening and selection: GMP, DC, JYT, and VG; Manuscript drafting: GMP, MM, MG, ER, and AG; Manuscript revision: GMP, AG, and DC. Supervision: GMP, AN, and DC.

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Correspondence to Giacomo Maria Pirola.

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Pirola, G.M., Naselli, A., Maggi, M. et al. Vacuum erection device for erectile function rehabilitation after radical prostatectomy: which is the correct schedule? Results from a systematic, scoping review. Int J Impot Res (2023). https://doi.org/10.1038/s41443-023-00700-w

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