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Viagra aids some prostate surgery patients
``These findings should encourage urologists to continue to perform and perfect the nerve-sparing approach to give their patients the best chance of successful treatment for impotence after prostatectomy,'' write the researchers, led by Dr. Craig D. Zippe of The Cleveland Clinic Foundation in Ohio.
and colleagues tested Viagra
, a drug that results in increased blood flow to the penis, on 28 men who had undergone prostatectomy roughly a year earlier.
Fifteen of the men had had bilateral nerve-sparing surgery, which left both sets of penile nerves intact.
Another 3 had had unilateral nerve sparing surgery, which left 1 set intact.
The remaining 10 had had non-nerve sparing surgery.
and colleagues interviewed the men and their spouses both before the men tried Viagra
, also known as sildenafil citrate, and after the men had taken the drug.
Of the men who had had bilateral nerve sparing surgery, 80% had erections sufficient for intercourse after taking 1 to 3 doses of Viagra
Moreover, 80% of the spouses of the men who had had bilateral nerve sparing surgery reported being satisfied with intercourse after their partners took Viagra
, the researchers report.
In contrast, none of the men who had erectile dysfunction after either unilateral nerve sparing surgery or non-nerve sparing surgery responded to the drug, according to Zippe
Since all of the men in the study had undergone surgery about a year prior to starting Viagra, it is ``quite possible that earlier initiation of sildenafil might increase the positive response rate,'' in men who have had either unilateral or non-nerve-sparing prostatectomy, Zippe and colleagues speculate.
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"By excluding clinical categories that produce false-positive results, the specificity and positive predictive value of the NMP22 test were significantly improved while maintaining excellent sensitivity," said Craig Zippe, Co-Director at the Cleveland Clinic Foundation's Urological Institute and principal investigator of the study.
Article on Laparoscopic prostate cancer surgery from Boston Globe 1/26/01
''The big advantage is that at two weeks after surgery, my laparoscopic patients are doing everything: shopping, working in the garden,'' said Dr. Craig Zippe, a urologist at the Cleveland Clinic, where the procedure has been done more than 60 times.
''It really takes about six weeks for a guy who's had the [standard] open procedure'' to regain his
previous strength, Zippe
Craig Zippe, ...
Craig Zippe, M.D.
...Craig D. Zippe, MD, is a Staff Surgeon in the Section of Urologic Oncology at Cleveland Clinic.He
was appointed to the Cleveland Clinic
staff in 1994 as Co-director of the Prostate Center
.Dr. Zippe completed his general surgical training at Duke University and subsequently graduated from the urologic residency program at Columbia University in New York under the direction of Dr. Carl Olsson.
...Following graduation from his fellowship, Dr. Zippe became Director of Urologic Oncology at Beth Israel Medical Center in New York from 1992-1994.Dr. Zippe's
specific research interests include the surgical management of localized prostate cancer, the management and treatment of surgical and radiation therapy failures, the role of urinary tumor markers in screening and monitoring bladder cancer and the construction of an effective, time-efficient orthotopic urinary bladder.He
has considerable clinical experience in the field of urologic oncology, having performed more than 500 radical prostatectomies and more than 100 radical cystectomies.He
has been interested in the surgical complication following radical pelvic surgery.He has authored landmark publications on the use of sildenafil citrate following radical prostatectomy and he continues to research the etiology and prevention of post-prostatectomy erectile dysfunction.Dr. Zippe has more than 100 peer-reviewed publications in the subspecialty field of urologic oncology, and he is an expert reviewer on the subject of urologic oncology for several major journals, which include Urology, Journal of Urology, and Cancer.