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Adherence and barriers to penile rehabilitation over 2 years following radical prostatectomy

BMC Urology Oct 15, 2019

Albaugh J, et al. - Given the availability of a variety of penile rehabilitation (PR) therapies to improve postprostatectomy erectile dysfunction with mixed results, researchers examined adherence to PR treatment in men who underwent radical prostatectomy as well as assessed the barriers to its adherence. In this longitudinal cross-sectional study that was performed over 2 years, they instructed men to take a PDE5 inhibitor (PDE5i) three times per week, and if required, utilize a vacuum constriction device (VCD) daily. Enrollment of 77 patients was done; of these, only 49 completed evaluation at 3 or more time points and were incorporated in the analysis. As per outcomes, erectile and orgasm parameters improve over time, however, most men do not return to baseline function. Poor adherence was reported for PDE5i and VCD despite comprehensive instructions and a frequent follow-up schedule. They observed high reduction rates with only 55.8% of men remaining at 12 months and 45% of men completing 24 months. Cost, inconvenience and perceived ineffectiveness were the most common barriers to PR adherence.
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