Penile vibratory stimulation as rehabilitation of erectile function following nerve-sparing radical prostatectomy: A quantitative pilot study

Penile vibratory stimulation (PVS) has shown promise in aiding recovery of erectile function after radical prostatectomy. This prospective cohort pilot study aimed to determine optimized settings in preparation of a randomized controlled trial to further asses its effects. Men without prior erectile dysfunction were instructed to use a mechanical medical vibrator daily for six months following surgery and to adjust settings according to preferences. The primary objective was the optimized parameters defined by the time spent using the vibrator, along with the most frequently used amplitude and frequency settings. Secondary outcomes included patient acceptance and settings most often inducing erections and orgasms. Twenty men were included, 19 of whom used the device on a median of 40.1% of days (IQR: 28,8-51,4%). PVS was most often performed for 5 min (IQR: 5-10 min) and the most frequently used amplitude and frequency were 1 mm and 90 Hz. These parameters were also the ones to induce erections and orgasms most often. At 6 months, 12/19 men were able to engage in penetrative sex. Fourteen patients reported satisfaction with the device, and no adverse effects were observed. Altogether, patient-optimized parameters consisting of 5 min daily stimulation at an amplitude of 1 mm and a frequency of 90 Hz were the most used and showed the strongest association with both erections and orgasms. These parameters will be used in a larger randomized trial.