A CONSERVATIVE TREATMENT OPTION FOR VENOUS LEAKAGE IN IMPOTENT MEN Frank Sommer Abstract nr. Urologist & Specialist in Sportsmedicine, www.maennergesundheit.info 603 Prevalence of erectile dysfunction Introduction Anatomy Results Aim of the present study: •Incidence of impotence after the age of 40 - 70years rapidly increases from 5.6% to 61% • 35 to 60% of men with ED had venous leakage or insufficience of the veno-occlusive system „Cologne 8.000 Men Survey“ Assessment of the influence on penile rigidity 60 of a special designed IC 50,7 and BC (pelvic floor) 40 34 exercise programm – % named VigorRobic® - in 20 patients suffering from mild 12,8 7,3 to medium venous leakage 2,4 0 or insufficience of the veno30-39 y. 40-49 y. 50-59 y. 60-69 y. 70-80 y. occlusive system. age •36 got oral PDE5-inhibitor Method • Training programme was agiven 3 times, in weekly asessions. • Potence-evaluated by a well avalidated German questionnaire of aErectile Dysfunctiona(KEED), (three arms: 1. special pelvic floor programm, 2. oral PDE5-inhibitor on demand, 3. placebo) a(IC) and bulbocavernosus (BC) amuscles are very important in the aprocess of penile rigidity • Patients assessement: • history and examination • colour flow duplex doppler ultrasonography • dynamic infusion caversonometry & -graphy • were indicated Rigiscan nocturnal penile tumescence testing Results IIEF-Q3 and 4 and GAQ first visit, after 4 weeks and after 3 months • Cavernosometry: after 3 months Results •16 patients wanted other treatment options (Two in the pelvic floor exercise group, 4 of the oral drug group,14from the placebo group) •40 patients did pelvic floor exercises Subjects •124 impotent patients • placebo controlled trial • Contractions of the ischiocavernosus Localisation Localisation of of IC IC Muscle Muscle E.D. •28 got a placebo There was significant difference in the subjective results by the pelvic floor exercise group (80% of the patients got better erections) and PDE5-inhibitor (74%) compared to placebo (18%). Additionally an improvement of penile rigidity was measured in the pelvic floor exercise group of mean 46% after 3 months. Conclusion 180 170 160 150 140 130 120 110 100 90 80 70 60 50 25 C hange of Maintenance-Flow (m l/m in) * Time pe nile pre ssure EMG-activity and pressure in the corporal cavernosal body during erections with musclecontract ion 180 170 160 150 140 130 120 110 100 90 80 70 60 50 Tim e C hanges of KEED in com parison to "Baseline-Sc ore" penile pressure (m EMG-activity and pressure in the corporal cavernosal body during erections without musclecontraction No significabt change compared to initial measurement 20 15 10 * 5 0 * 7 *** p < 0,001 versus Placebo 6 5,8 5,9 *** *** "on dem and" pelvic floor exerc is e 5 4 3 2 1 0,3 0 Plac ebo -5 Placebo „on demand“ Pelvic floor exercise Pelvic floor exercise is a realistic conservative alternative treatment option in patients with mild to medium degrees of venous leakage or insufficience of the venoocclusive system.