MINIMALLY INVASIVE THERAPIES IN THE TREATMENT OF ERECTILE DYSFUNCTIONIN ANTICOAGULATED CASES - A STUDY OF SATISFACTION AND SAFETY

Purpose: We evaluated patient satisfaction with and the safety of vacu um therapy and self-injection during warfarin treatment of impotent me n. Materials and Methods: In a 24-week prospective study 33 patients w ere assigned to vacuum therapy or intracavernous injections with cross over at 12 weeks. Patients maintained diaries, and were followed with physical examinations, coagulation studies and questionnaires. Results : Of the 33 patients 26 completed the study with 706 vacuum applicatio ns (mean 1.9 weekly) and 605 injections (mean 1.6 weekly). There were 11 acute minor complications with vacuum therapy (petechiae that resol ved spontaneously) and no chronic complications. Only quality of clima x was diminished with vacuum therapy. Self-injection resulted in acute minor complications (3 ecchymoses and 1 prolonged erection requiring intervention) and 1 chronic complication (corporeal fibrosis with mild curvature). Conclusions: The adverse effects of vacuum therapy and in tracavernous self-injection in patients on warfarin do not exceed the rate in the general urological population. These therapies appear to b e safe in patients receiving warfarin.