Penile rehabilitation with a vacuum erectile device in an animal model is related to an antihypoxic mechanism: blood gas evidence.
Level 5 - mechanism / opinion, no new human data
Animal laboratory experiment with no human clinical data
PubMed 23564044 · doi:10.1038/aja.2013.18
What was done
Thirty adult Sprague-Dawley rats were randomly assigned to three groups: sham surgery, bilateral cavernous nerve crush (BCNC), or BCNC plus vacuum erectile device (VED) therapy. Penile length and diameter were measured weekly over 4 weeks of therapy. Cavernous blood was extracted by three methods to measure oxygen saturation (SO2) via blood gas analysis: flaccid state, traction state, and immediately following VED application.
What was found
VED therapy significantly reduced penile shrinkage compared to untreated BCNC: penile shortening was 0.3 ± 1.0 mm in the VED group versus 1.9 ± 1.1 mm in the BCNC group (P < 0.01), and penile diameter reduction was 0.04 ± 0.14 mm versus 0.28 ± 0.14 mm (P < 0.01). Cavernous SO2 increased with VED application to 88.25% ± 4.94%, compared with 76.53% ± 4.16% in flaccid and 78.93% ± 2.56% in traction states (P < 0.05). Corpus cavernosum blood composition after VED was calculated to be 62% arterial and 38% venous.
Why it matters
This study demonstrates a physiological mechanism for vacuum therapy in penile rehabilitation, indicating that VED counters hypoxia after cavernous nerve injury by drawing oxygenated arterial blood into the erectile tissue.
Limits
Findings are restricted to a small rodent model (n = 30) and cannot be directly assumed to translate to human post-prostatectomy rehabilitation. The abstract does not report whether spontaneous erectile function recovered or evaluate long-term outcomes after discontinuation of therapy.
Cited by
- supports A lack of regular or nocturnal erections reduces blood flow to the penis, causing the penis to shrink over time.