A CONSERVATIVE TREATMENT OPTION FOR VENOUS LEAKAGE IN IMPOTENT MEN Introduction

A CONSERVATIVE TREATMENT OPTION FOR VENOUS LEAKAGE IN IMPOTENT MEN
Frank Sommer
Abstract nr.
Urologist & Specialist in Sportsmedicine, www.maennergesundheit.info
603
Prevalence of erectile dysfunction
Introduction
Anatomy
Results
Aim of the present study:
•Incidence of impotence after
the age of 40 - 70years
rapidly increases from 5.6%
to 61%
• 35 to 60% of men with ED
had venous leakage or
insufficience
of the veno-occlusive system
„Cologne 8.000 Men Survey“ Assessment of the
influence on penile rigidity
60
of a special designed IC
50,7
and BC (pelvic floor)
40
34
exercise programm –
%
named VigorRobic® - in
20
patients suffering from mild
12,8
7,3
to medium venous leakage
2,4
0
or insufficience of the veno30-39 y. 40-49 y. 50-59 y. 60-69 y. 70-80 y.
occlusive system.
age
•36 got oral PDE5-inhibitor
Method
• Training programme was agiven 3
times, in weekly asessions.
• Potence-evaluated by a well
avalidated German questionnaire of
aErectile Dysfunctiona(KEED),
(three arms: 1. special pelvic floor programm, 2. oral PDE5-inhibitor on demand, 3. placebo)
a(IC) and bulbocavernosus (BC)
amuscles are very important in the
aprocess of penile rigidity
• Patients assessement:
• history and examination
• colour flow duplex doppler ultrasonography
• dynamic infusion caversonometry & -graphy
• were indicated Rigiscan nocturnal penile
tumescence testing
Results
IIEF-Q3 and 4 and GAQ
first visit, after 4 weeks and after 3
months
• Cavernosometry: after 3 months
Results
•16 patients wanted other treatment options
(Two in the pelvic floor exercise group, 4 of
the oral drug group,14from the placebo
group)
•40 patients did pelvic floor exercises
Subjects
•124 impotent patients
• placebo controlled trial
• Contractions of the ischiocavernosus
Localisation
Localisation of
of IC
IC Muscle
Muscle
E.D.
•28 got a placebo
There was significant difference in the
subjective results by the pelvic floor
exercise group (80% of the patients got
better erections) and PDE5-inhibitor (74%)
compared to placebo (18%).
Additionally an improvement of penile
rigidity was measured in the pelvic floor
exercise group of mean 46% after 3
months.
Conclusion
180
170
160
150
140
130
120
110
100
90
80
70
60
50
25
C hange of Maintenance-Flow (m l/m in)
*
Time
pe nile pre ssure
EMG-activity
and pressure
in the corporal
cavernosal
body during
erections with
musclecontract
ion
180
170
160
150
140
130
120
110
100
90
80
70
60
50
Tim e
C hanges of KEED in com parison to "Baseline-Sc ore"
penile pressure (m
EMG-activity and pressure in the corporal cavernosal body during
erections without musclecontraction
No significabt change compared to initial measurement
20
15
10
*
5
0
*
7
*** p < 0,001 versus Placebo
6
5,8
5,9
***
***
"on dem and"
pelvic floor exerc is e
5
4
3
2
1
0,3
0
Plac ebo
-5
Placebo
„on demand“
Pelvic floor exercise
Pelvic floor exercise is
a realistic conservative alternative treatment option in
patients with mild to medium
degrees of venous leakage
or insufficience of the venoocclusive system.