Robot yardımlı transperitoneal radikal prostatektomi sonrası erektil disfonksiyon tedavisinde intrakavernozal alprostatilin etkinliği ve hasta memnuniyetinin değerlendirilmesi

Abstract

Amaç: Robot yardımlı radikal prostatektomi (RARP) sonrası erektil disfonksiyon (ED) önemli bir problem olup, bu çalışmada ED tedavisinde kullanılan intrakavernozal alprostadilin etkinliğini ve hasta memnuniyetini değerlendirmeyi amaçladık.
Gereç ve Yöntemler: RARP sonrası ED tedavisinde intrakavernozal alprostadil kullanan hastalar retrospektif olarak değerlendirildi. Hastaların demografik özellikleri, operasyon öncesi ve sonrası International Index of Erectile Function (IIEF) skorları ve genel memnuniyeti IIEF form 13. ve 14. soruları ile değerlendirilerek kayıt altına alındı. Tedavi sürecinde gelişen komplikasyonlar, kullanım dozları ve bırakma nedenleri incelendi.
Bulgular: Araştırmaya toplam 34 hasta alındı. Hastaların yaş ortalaması 61.73±5.80 yıldı. Hastaların % 52.9’unda (n=18) preoperatif ED tespit edildi. Hastaların preoperatif, postoperatif 1. ay, postoperatif 3 ay tadalafil kullanımı sonrası ve intrakavernozal alprostadil kullanan hastaların İEFF ortalaması sırasıyla 20.64±3.46, 15.08±2.09, 15.32±2.18, 26.67±2.30’ du. Hastaların intrakavernozal Alprostadil kullanma sürelerinin ortalaması 8.20±2.48 ay’ dı ve % 70.58’inde tam ereksiyon sağladığı görüldü. İntrakavernozal Alprostadil kullanımına bağlı hastaların, %2.9’unda hematom, %8.8’inde ekimoz, %11.8’inde ağrı gelişti. Hastaların takip süresi içerisinde %73.5’inin ilaca devam ettiği tespit edildi. Hastaların alprostadil tedavisi sonrası istatistiksel olarak anlamlı derecede genel memnuniyetlerinin yüksek olduğu görüldü.
Sonuç: RARP sonrası, intrakavernozal alprostatil tedavisi, tam ereksiyon sağlamada sonuçlarının yüksek olması, düşük komplikasyon oranları ve yüksek hasta memnuniyeti ile iyi bir tedavi seçeneğidir.

Keywords

• Alprostadil
• Erektil disfonksiyon
• robot yardımlı radikal prostatektomi

Evaluation of the efficacy and patient satisfaction of the intracavernosal alprostadil in the treatment of erectile dysfunction following robot-assisted radical prostatectomy

Abstract

Objective: Erectile dysfunction (ED) following robot-assisted radical prostatectomy (RARP) is an important problem. The purpose of this study was to evaluate the effectiveness of and patient satisfaction with intracavernosal alprostadil used in the treatment of ED.
Material and Methods: Patients using intracavernosal alprostadil in the treatment of ED following RARP were assessed retrospectively. Patients’ demographic characteristics, pre- and postoperative International Index of Erectile Function (IIEF) scores, and general satisfaction evaluated using questions 13 and 14 of the IIEF form were all recorded. Complications developing during treatment, dosages used, and reasons for discontinuation were investigated.
Results: Thirty-four patients with a mean age of 61.73±5.80 years were included in the study. Preoperative ED was determined in 52.9% (n=18) of patients. The mean IEFF of the patients who used preoperative, postoperative 1st month, postoperative 3 months after tadalafil use and intracavernosal alprostadil was 20.64 ± 3.46, 15.08 ± 2.09, 15.32 ± 2.18, 26.67 ± 2.30, respectively. The mean length of use of intracavernosal alprostadil was 8.20±2.48 months, and full erection was achieved in 70.58% of patients. Hematoma associated with intracavernosal alprostadil use developed in 2.9% of patients, ecchymosis in 8.8%, and pain in 8.8%. In addition, 73.5% of patients continued to take their medication during the follow-up process. Patients’ general satisfaction following alprostadil therapy was statistically significantly high.
Conclusion: Intracavernosal alprostadil therapy following RARP represents a good therapeutic option due to its high success in achieving full erection, low complication rates, and high patient satisfaction.

Keywords

• erectile dysfunction
• Alprostadil
• robot-assisted radical prostatectomy

Supporting Institution

None

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