{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:14:21Z","timestamp":1768436061796,"version":"3.49.0"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,10,26]],"date-time":"2024-10-26T00:00:00Z","timestamp":1729900800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006093","name":"Patient-Centered Outcomes Research Institute","doi-asserted-by":"publisher","award":["ME\u20102018C2\u201013253"],"award-info":[{"award-number":["ME\u20102018C2\u201013253"]}],"id":[{"id":"10.13039\/100006093","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Andrology"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Intracavernosal injection therapy is often used as second\u2010line therapy for erectile dysfunction associated with radical prostatectomy when therapy with phosphodiesterase\u20105 inhibitors has failed, but prostaglandin E1\u2010containing vasoactive agents are associated with penile pain in some men.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To define the incidence of pain with prostaglandin E1\u2010containing intracavernosal injection\u00a0mixtures for erectile dysfunction associated with radical prostatectomy when therapy with phosphodiesterase\u20105 inhibitors has failed, and whether pain\u00a0was\u00a0a predictor of erectile function recovery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Men who underwent radical prostatectomy and\u00a0were\u00a0commenced\u00a0on\u00a0intracavernosal injection within 12 months of radical prostatectomy were included. A pain visual analog scale (0\u201310) was used to assess the degree of pain. Erectile function recovery was defined as\u00a0the International Index of Erectile Function domain score \u226524\u00a0using phosphodiesterase\u20105 inhibitors at 24\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 566 patients, mean age was 58\u00a0\u00b1\u00a014 (42\u201374) years. Duration post\u2010radical prostatectomy at intracavernosal injection training was 3.5\u00a0\u00b1\u00a03.5\u00a0m. Nerve sparing status: bilateral 76%, unilateral 13%, and non\u2010nerve sparing 11%. Incidence of pain with intracavernosal injection per nerve sparing status: bilateral 10% of patients, unilateral 32%, non\u2010nerve sparing 92% (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). Median visual analog scale in those experiencing pain: bilateral 4 (interquartile range 3, 5), unilateral 5.5 (interquartile range 3, 6), non\u2010nerve sparing 7 (interquartile range 3, 9) (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). Phosphodiesterase\u20105 inhibitors success at 24\u00a0months (no pain vs. pain): bilateral 70%\u00a0vs. 40% (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), unilateral 50%\u00a0vs. 28% (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), non\u2010nerve sparing 10%\u00a0vs. 0% (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). On multivariate analysis, predictors of failure to respond to phosphodiesterase\u20105 inhibitors at 24\u00a0months post\u2010radical prostatectomy included baseline erectile function, increasing age, incomplete nerve\u2010sparing surgery, and presence of pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The presence of penile pain with intracavernosal injection is associated with poorer erectile function recovery post\u2010radical prostatectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Incidence of pain is high in men with non\u2010nerve sparing radical prostatectomy; older patient age, poorer nerve sparing, poor baseline erectile function, and the presence of penile pain with prostaglandin E1\u2010containing intracavernosal injection medication, were predictive of poor erectile function recovery using phosphodiesterase\u20105 inhibitors at 24\u00a0months.<\/jats:p><\/jats:sec>","DOI":"10.1111\/andr.13784","type":"journal-article","created":{"date-parts":[[2024,10,27]],"date-time":"2024-10-27T01:58:06Z","timestamp":1729994286000},"page":"1484-1489","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Pain associated with prostaglandin E<sub>1<\/sub>\u2010containing intracavernosal injection medication is associated with poor erectile function recovery after radical prostatectomy"],"prefix":"10.1111","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9887-5800","authenticated-orcid":false,"given":"Michael","family":"West","sequence":"first","affiliation":[{"name":"Sexual and Reproductive Medicine Program, Urology Service Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Billy H.","family":"Cordon","sequence":"additional","affiliation":[{"name":"Sexual and Reproductive 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