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Oxygenation Status of the Cavernosal Tissue after the Direct Action of the Vacuum Device

This study aims at comparing the oxygenation status of the cavernosal tissue after the direct action of the Vacuum device (VD) preceded or not by administration of Sildenafil. Patients and methods. We enrolled thirty patients who had undergone perineal radical prostatectomy. After four weeks from surgery we evaluated oxygen pressure (pO2), carbon dioxide pressure (pCO2) and O2 saturation in cavernosal blood. The pts were divided in 2 groups: 15 pts used only Vacuum device (first group), while the other 15 took Sildenafil 50 mg one hour before the exercise with VD (second group) for approximately 30 minutes without constriction band. Cavernous blood gas analyses pre- e post-exercising with the VD were repeated at the end of the complete 3-month rehabilitation program. The data obtained were processed by statistical analysis using the Student t test. Results During flaccidity at baseline, average levels of pO2, pCO2 and O2% saturation rates were respectively 30.07+/-2.91, 39.60+/-6.47, and 65.93+/-2.15 in the first group and 31.20+/-8.1, 42.64+/-7.64 and 52.87+/-8.95 in the second group. Mean values of pO2 rates increased after both treatments with higher oxygenation levels in the second group. At the end of the study pO2 and O2 saturation levels in the second group were found to be 68.5+/-6.87 (p>0.05) and 92.8+/- 2.66 (n.s.) versus levels of 63.8+/- 4.61 and 91.6+/-2.79 in the first group. No significant variations were found in partial CO2 pressure between the two groups (38.13+/-3.52 vs 38. 13+/-6.62). Conclusions In patients presenting with ED after radical prostatectomy, treatment with exercising of erectile tissue by means of an intermittent Vacuum device without constriction band can locally improve oxygenation levels. The addition of Sildenafil offers a further increase of oxygenation levels in the cavernosal tissue.