THE EFFECT OF CRYOSURGICAL ABLATION OF THE PROSTATE ON ERECTILE FUNCTION

Objective To investigate the incidence and identify the possible cause of erectile dysfunction after cryoablation of the prostate. Patients and methods Erectile function was examined prospectively in 15 sexuall y active men (aged 59-72 years) who underwent cryoablation of the pros tate for clinically localized prostate cancer. Erectile function was a ssessed before and 6 months after treatment; after intracavernosal inj ection with 10 mu g of prostaglandin E1 (PGE1). the degree and duratio n of erection, the size of the cavernosal arteries, the penile arteria l blood flow velocity, and the time to achieve peak flow were evaluate d using high-resolution ultrasonography and colour pulsed-Doppler spec tral analysis. Results Post-operatively, all patients initially report ed an inability to achieve an erection sufficient for vaginal intercou rse, At 6 months' follow-up, erectile dysfunction persisted in nine, w ith minimal or no response to the intracavernosal PGE1 injections, the re was a significant decrease in the peak velocity of blood flow withi n cavernosal arteries and a significant increase in the time to achiev e peak arterial now, Conclusion Although many factors may contribute t o erectile dysfunction after cryoablation of the prostate, vascular in jury plays a major role.