Minimally Invasive Therapies in the Treatment of Erectile Dysfunction in Anticoagulated Cases: A Study of Satisfaction and Safety

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Abstract
We evaluated patient satisfaction with and the safety of vacuum therapy and self-injection during warfarin treatment of impotent men. In a 24-week prospective study 33 patients were assigned to vacuum therapy or intracavernous injections with crossover at 12 weeks. Patients maintained diaries, and were followed with physical examinations, coagulation studies and questionnaires. Of the 33 patients 26 completed the study with 706 vacuum applications (mean 1.9 weekly) and 605 injections (mean 1.6 weekly). There are 11 acute minor complications with vacuum therapy (petechiae that resolved spontaneously) and no chronic complications. Only quality of climax was diminished with vacuum therapy. Self-injection resulted in acute minor complications (3 ecchymoses and 1 prolonged erection requiring intervention) and 1 chronic complication (corporeal fibrosis with mild curvature). The adverse effects of vacuum therapy and intracavernous self-injection in patients on warfarin do not exceed the rate in the general urological population. These therapies appear to be safe in patients receiving warfarin.