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.