Research Article Penile Hemodynamic Response to Phosphodiesterase Type V Inhibitors after Cavernosal Sparing Inflatable Penile Prosthesis Implantation: A Prospective Randomized Open-Blinded End-Point (PROBE) Study Adham Zaazaa , 1 Michaela Bayerle-Eder, 2 Ramzy Elnabarawy , 1 Mahmoud Elbitar, 1 and Taymour Mostafa 1 1 Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo 11562, Egypt 2 Department of Endocrinology & Metabolism, Medical University of Vienna, W¨ ahringer G¨ urtel 18–20, Vienna 1090, Austria Correspondence should be addressed to Adham Zaazaa; adhamzaazaa@gmail.com Received 27 January 2021; Revised 11 June 2021; Accepted 18 June 2021; Published 28 June 2021 Academic Editor: Mohammad H. Ather Copyright©2021AdhamZaazaaetal.isisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Forceful corporal dilatation amidst penile prosthesis implantation may injure cavernosal arteries compromising penile vas- culature. In this study, we aimed to compare the conventional and cavernosal sparing techniques regarding cavernosal artery preservation. Overall, 33 patients underwent inflatable penile prosthesis implantation with Coloplast Titan Touch ® three-piece inflatable penile implants. 16 patients had conventional implantations with serial vigorous dilatations, while 17 patients were implanted with the cavernosal sparing technique, consisting of a single minimal corporal dilatation after an intraoperative intracavernosal injection (ICI) of Alprostadil. Postoperatively, a penile duplex Doppler ultrasound study was performed. Whenever a cavernosal artery was spared and thus successfully probed, its hemodynamics were studied before and after an oral administration of a phosphodiesterase type 5 inhibitor (PDE5i). A cavernosal artery was successfully probed in 16/17 (94%) of patients in the cavernosal sparing group compared to 5/16 (31%) of patients in the conventional group with a significant statistical difference (P � 0.001). is demonstrated that the cavernosal sparing technique was superior to the conventional approach in preserving the cavernosal artery (odds ratio 35.2, 95% IC 3.5–344.2; P � 0.0022). Whenever a cavernosal artery could be probed, its hemodynamic responsiveness was also preserved. is trial is registered with NCT03733860. 1. Background Since the advent of the inflatable penile prosthesis (IPP) in 1973, it has become the surgical gold standard in treating patients with refractory erectile dysfunction (ED) [1, 2]. ree-piece inflatable implants have shown greater satis- faction among patients compared to the semi-rigid rods, due to their better concealability and more natural erections [3]. Patients’ satisfaction rates after three-piece inflatable im- plants have been estimated to be up to 98% and up to 96% among their partners [4]. Corporal dilatation during penile prosthesis implanta- tion procedures can injure the cavernosal arteries. is would compromise the blood supply of the corpora and make them solely dependent on the dorsal and bulbourethral arteries. e postoperative application of tight dressings could then potentially compress these arteries against the underlying cylinders resulting in distal ischemia [5]. Cavernosal arteries also play an indirect role in glandular tumescence. e glans penis is mainly supplied by the dorsal arteries and the terminal branches of the spongiosal arteries. Glandular tumescence is partly caused by compression of the Hindawi Advances in Urology Volume 2021, Article ID 5548494, 7 pages https://doi.org/10.1155/2021/5548494