Introduction: Balloon angioplasty (BA) has been applied to treat arteriogenic erectile dysfunction (ED), however, the durability of treatment effect is variable. The purpose of current study is to discuss the effect of BA and if vacuum erection device (VED) can enhance or extend the effects of BA for patients with arteriogenic ED.
Methods: Nine ED patients with poor response to both oral phosphodiesterase inhibitors and intracavernous injection were included from January 2018 to March 2019. All patients were studied with computed tomographic angiography (CTA) to confirm the sites of stenosis in the ilio-pudendal-penile arterial system. All patients received angiography, and BA was successfully accomplished in 8 patients. The International Index for Erectile Dysfunction-5 (IIEF) score and Erection Hardness Score (EHS) were collected before and after treatments. Among them, 5 patients used VED (10 pumps per day without applying constricting band) for 6 months, and the other 3 served as control.
Results: Mean age of the 9 patients was 59.6 years. All patients had normal testosterone levels. Baseline median IIEF was 6 (from 4 to 10) and median EHS was 2. All the vascular stenotic lesions were unilateral (7 at penile artery (PA) and 2 at internal pudendal artery (IPA)). One month after BA, the median IIEF score significantly improved from 6 to 12 (p = 0.001) and EHS increased from 2 to 3 (p = 0.024). For the 5 patients using VED after BA, median IIEF continued to improve to 24 (p =0.043) and median EHS increased to 4 (p = 0.025) at 6 months after BA. For the 3 control patients, there was no more improvement of IIEF or EHS seen at 6 months. There was no complication occurred in both groups during the follow-up.
Conclusions: In patients with arteriogenic ED, BA for IPA or PA stenosis is safe and can moderately improve erectile function. While adding VED after BA, the improvement can be further enhanced the treatment effect significantly extended. We recommend to add on VED after BA as an adjuvant strategy for patients with arteriogenic ED.
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