From November 1985 to April 1990, 216 consecutive
patients were treated with the vacuum constriction device.
Patients were mailed an initial questionnaire (group 1) and a
long-term questionnaire (group 2) at a median follow-up of 3 and 29
months, respectively. Of 202 available patients 161 in group 1 (75%)
and 115 in group 2 (57%) responded. Regular use of the vacuum
constriction device was reported by 69% group 1 and 70% group 2
patients.
Patient and partner satisfaction was 82% and 87% in group 1, and 84%
and 89% in group 2, respectively.
There were no significant differences between the groups with
respect to regular use and patient or partner satisfaction.
Quality of erection was evaluated for hardness, length and
circumference, and with satisfaction greater than 90% in both
groups. Median times per month of successful intercourse were 1, 4
and 4 for the year before, during and after obtaining the vacuum
constriction device in group Also, 79% of the patients in group 2
reported a statistically significant increase in the frequency of
intercourse per month in the first year, which was sustained beyond
the first year in 77% ). Our results support the efficacy of the
vacuum constriction device for the treatment of impotence. Overall
regular use rates as well as patient and partner satisfaction appear
to be high. Furthermore, excellent initial results appear durable in
most patients.
The impact of impotence on health care dollars can be expected to
grow as the number of elderly patients at highest risk for erectile
dysfunction continues to increase. Despite a wide variety of
treatment options, there is an increasing trend toward the
nonoperative management of impotence.
While intracavernosal injection of vasoactive drugs is an excellent
form of therapy in selected patients, concerns over potential Vacuum
constriction devices have now gained widespread acceptance in the
management of impotence.
High rates of success and patient satisfaction with the vacuum
constriction device combined with its relatively low cost and safety
have helped to establish its clinical efficacy.
Furthermore, scientific studies, including the work of Diederichs et
al demonstrating the effects of subatmospheric pressure on the
simian penis, have given further credibility to and understanding of
the use of vacuum constriction devices in the treatment of
impotence.
Despite its present popularity, few reports exist in the literature
addressing success or patient and partner satisfaction with regard
to the long-term use of vacuum constriction devices. Our
investigation was conducted to determine if initial early success
and satisfaction with vacuum constriction devices remained constant
with long term use. Also, an attempt was made to evaluate the
quantitative and qualitative impact of the vacuum constriction
device on the sexual practices of these patients.
Between November 1985 and April 1990 a total of 559 men underwent
evaluation for the treatment of impotence, including a complete
history and physical examination; laboratory tests and more
extensive studies were performed as indicated. These patients were
evaluated by a single urological practice and the extent of the
evaluation was at the discretion of the examiner based on the
"patient's goal directed approach" as described by Lue. |
