Intracavernosal injections (ICI) are commonly used to treat erectile dysfunction in men following radical prostatectomy (RP). Predictors of treatment success are still unclear.\nOur objective is to explore the relationship between various clinical and pathological parameters and the achievement of satisfactory erections with ICI following RP.\nA prospective study of men following RP with bilateral neurovascular bundle preservation who experienced erectile dysfunction refractory to treatment with phosphodiesterase type 5 inhibitors (PDE5I) at a minimum of 6 months after surgery. Three escalating dosages of TRIMIX were used consecutively (5mg Papaverine, 0.5 mg Phentolamine, 10mcg Alprostadil; 10mg Papaverine, 1 mg Phentolamine, 20 mcg Alprostadil; 17mg Papaverine, 1mg Phentolamine, and 30mcg Alprostadil). Erection Hardness Scale (EHS) and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) were used for functional assessments.\nThirty four patients were stratified by their EHS scores and Trimix dosages: low dose full responders (N=12), intermediate dose full responders (N=10), high dose partial responders (N=7), high dose failures (N=5). Twenty nine (85%) of the patients reported on satisfactory erectile function with ICI. The ICIQ-SF scores were the only parameter that correlated significantly with successful erectile response with mean scores of 2.58, 4.7, 9.57, and 14.8 for the respective groups above (p=0.001). Multivariate analysis identified ICIQ-SF as the only independent predictor of success (OR 0.74, p=0.002).\nICI is an efficient therapy for achieving satisfactory erections following RP in PDE5I-resistant men. Sustainable urinary incontinence is a strong predictor of poor response to therapy.
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