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The purpose of this study is to evaluate the feasibility of electrical stimulation of nerves responsible for erectile function to evoke penile erection after surgery to remove the prostate (prostatectomy).
Prostate cancer is the main cancer in men. However, the survival rate for clinically localized prostate cancer is prominent mainly due to radical prostatectomy (RP), the gold standard treatment for non-metastatic cancers. Unfortunately, despite providing optimal cancer control, RP often lead to neuropraxia and persistent erectile dysfunction in approximately 80% of men 1 year after prostatectomy. Various erectile rehabilitation strategies have not been able to prove a beneficial action yet. However, electrical stimulation has been demonstrated to favour neuroregeneration and the functional recovery of neuromuscular systems and has been shown to induce and maintain penile erection in animals and humans. Therefore, electrical stimulation of the pelvic plexus nerves during radical prostatectomy is being investigated for its potential development into a treatment aimed at improving recovery of erectile function after prostatectomy.
The primary objective of this study is to explore the feasibility of using a neurostimulation device post radical prostatectomy as a method for neurogenic erectile dysfunction treatment. During standard open radical prostatectomy, the pelvic plexus nerves will be electrically stimulated intraoperatively and the modification of penile circumference will be recorded.
The secondary objective is to assess proper placement of the stimulation electrodes and stimulation parameters needed to achieve maximal change in penile circumference.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Nerve Stimulation | Experimental | Acute placement of electrodes and electrostimulation of the pelvic plexus nerves during open radical prostatectomy. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Nerve Stimulation | Device | Acute placement of electrodes on the pelvic plexus to apply electrostimulation during open radical prostatectomy. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Penile circumference increase in millimeters. | Change in penile circumference [mm] in response to electrical stimulation of the pelvic plexus nerves measured by a penile plethysmograph. | 5 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Anatomic location of stimulation site | The anatomic location of the stimulation site on the pelvic floor (determined by the surgeon). | 5 to 15 minutes |
| Stimulation threshold in volts | Amplitude in volts of the electrical stimulation pulses to induce penile response. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Spyridon Skoufias, MD | Contact | spyskouf@hotmail.com | spyskouf@hotmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Ioannis Adamakis, MD | Laikon General Hospital of Athens | Principal Investigator |
| Constantinos A. Constantinides, MD | Laikon General Hospital of Athens | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Laikon General Hospital of Athens | Recruiting | Athens | 11527 | Greece |
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| ID | Term |
|---|---|
| D007172 | Erectile Dysfunction |
| D011471 | Prostatic Neoplasms |
| ID | Term |
|---|---|
| D005832 | Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D012735 | Sexual Dysfunction, Physiological |
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| 5 to 15 minutes |
| D052801 | Male Urogenital Diseases |
| D020018 | Sexual Dysfunctions, Psychological |
| D001523 | Mental Disorders |
| D005834 | Genital Neoplasms, Male |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D011469 | Prostatic Diseases |