A Systematic Review of the Role of Penile Rehabilitation in Prostate Cancer Patients Receiving Radiotherapy and Androgen Deprivation Therapy

Doherty, Wesley; Bridge, Pete

doi:10.1016/j.jmir.2018.09.004

Cited by 7 publications

(3 citation statements)

References 52 publications

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“…(19) Recent findings, however, indicate the therapeutic value of both medication and regular sexual activity in penile rehabilitation and long-term preservation of sexual function. (20)…”

Section: Causes Of Variabilitymentioning

confidence: 99%

Evaluation of seminal vesicle volume variability in patients receiving radiotherapy to the prostate

et al. 2019

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Introduction:Prostate positional variability has been widely explored with seminal vesicle (SV) variability, coming into the forefront only in recent years. While planning target volume (PTV) margins and preparation protocols ameliorate the effects of bladder and rectum volume changes on prostate, studies on SV variation have looked at only position, not volume variability.Aim:The aim of this study was to investigate whether the inter-fraction volume variability of the VSs can exist in patients receiving radiotherapy to the prostate.Method:SV variability was investigated by comparing four on-treatment cone beam computer tomography scans to a planning computer tomography (CT) image for two patients receiving prostate radiotherapy. For each case, variation in volumes (cm3) was compared with intra-observer variation.Results:SV volume variability was seen in both patients, with the largest change in volume being 78·38%. This variance was considerably (between 2 and 10 times) larger than the measured intra-observer variance.Conclusion:This study identified the potential for daily SV volume variability in patients receiving prostate radiotherapy. Future large-scale studies are warranted to identify the extent of this motion and potential clinical impact. Evidence-informed PTV margins and possible SV volume control protocols may need to be adopted.

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“…(19) Recent findings, however, indicate the therapeutic value of both medication and regular sexual activity in penile rehabilitation and long-term preservation of sexual function. (20)…”

Section: Causes Of Variabilitymentioning

confidence: 99%

Evaluation of seminal vesicle volume variability in patients receiving radiotherapy to the prostate

et al. 2019

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“…Penile rehabilitation is accepted as the standard of care in males following radical prostatectomy [ 10 11 ] and there is growing evidence to advocate its role in males receiving radiation therapy and ADT too [ 12 ]. While established pharmacotherapy for penile rehabilitation can be effective in restoring erectile function (EF), they may not affect underlying endothelial dysfunction which is thought to be the underlying basis for ED.…”

Section: Introductionmentioning

confidence: 99%

Impact of Physical Exercise Program Interventions on Erectile Function and Cardiovascular Health in Males with Prostate Cancer

Chung

Rhee

2022

World J Mens Health

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Prostate cancer (PC) and its associated treatments can cause significant cardiovascular and sexual dysfunctions. While structured exercise interventions can induce positive outcomes in males with PC, there are limited data on its effects on cardiovascular health, erectile function, or the combination of these outcomes. It has been proposed that positive changes in biomarkers of cardiovascular health through physical exercise programs, can result in cardiovascular remodelling and improve penile haemodynamic and erectile function recovery in those with metabolic syndrome and/or cardiovascular diseases, although the data is accruing in males who are diagnosed and/or treated for PC. While the results of this review article support structured physical exercise interventions to effectively prevent and mitigate the development of both sexual and cardiovascular dysfunctions in males with PC, appropriate caution should be maintained and future clinical research should focus on the development of standardised and evidence-based exercise guidelines in the setting of PC survivorship.

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“…There is mixed evidence on the efficacy of these treatments but, to date, they are considered the main approach to ED management following prostate cancer treatment [9]. Penile rehabilitation programs are also increasingly used, although there is no standard rehabilitation protocol and a lack of evidence of efficacy [10]. Penile implants can provide effective early sexual rehabilitation and improve quality of life without compromising surgical outcomes, although utilisation is low [11].…”

Section: Introductionmentioning

confidence: 99%

Experiences of Support for Sexual Dysfunction in Men with Prostate Cancer: Findings from a U.K.-Wide Mixed Methods Study

Watson

Wilding

Matheson

et al. 2021

The Journal of Sexual Medicine

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Background Men with prostate cancer (PCa) often experience sexual dysfunction following diagnosis and treatment, yet little is known about the support they receive to deal with this. Aim To explore men’s experiences of support for sexual dysfunction following PCa diagnosis. Methods This study included a U.K.-wide survey of men 18–42 months post-diagnosis of PCa, identified through cancer registries. The survey measured sexual function and the extent to which men perceived sexual dysfunction to be a problem (Expanded Prostate Cancer Index Composite-26), access to and experience of medications, devices, and specialist services for sexual dysfunction, and included a free-text question for further comments. Analysis focussed on men who reported poor sexual function, which they considered a moderate or big problem. Descriptive statistics explored the characteristics of men offered intervention and those that found this helpful. Free-text responses were analyzed using thematic analysis. Outcome The main outcome of this study was to assess access to and experience of medications, devices, and specialist services for sexual dysfunction. RESULTS 39.0% of all survey respondents (13,978/35,823) reported poor sexual function, which they considered a moderate or big problem. 51.7% of these men were not offered any intervention to aid sexual functioning. 71.9% of those offered an intervention reported trying it, of whom 48.7% found the intervention helpful. Men treated with surgery or brachytherapy were most likely to be offered an intervention. Medication was the most commonly offered intervention and 39.3% of those who tried medication found this helpful. Although offered less often, approximately half of the men who tried devices or attended specialist services found the intervention helpful. Free-text responses indicated that barriers to accessing support included inadequate information and support from healthcare professionals, embarrassment, negative views about treatment options, concerns about side effects and safety, and inconsistencies between secondary and primary care. Barriers to continuing use included limited effectiveness of treatments, inadequate ongoing support, and funding constraints. Drivers of sexual recovery included patient proactivity and persistence with trying different treatment options and ongoing support from health professionals. Clinical Implications There is an urgent need to ensure that all men are offered, and have equal access to, sexual care support, with referral to specialist services when required. Strengths & Limitations This study presents data from a large, U.K.-wide, population-based study of men with PCa and includes quantitative and qualitative findings. The possibility of non-response bias should, however, be considered. CONCLUSION There are significant shortcomings in the support offered to U.K. men with sexual dysfunction following diagnosis and treatment for PCa which need to be addressed.

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A Systematic Review of the Role of Penile Rehabilitation in Prostate Cancer Patients Receiving Radiotherapy and Androgen Deprivation Therapy

Cited by 7 publications

References 52 publications

Evaluation of seminal vesicle volume variability in patients receiving radiotherapy to the prostate

Evaluation of seminal vesicle volume variability in patients receiving radiotherapy to the prostate

Impact of Physical Exercise Program Interventions on Erectile Function and Cardiovascular Health in Males with Prostate Cancer

Experiences of Support for Sexual Dysfunction in Men with Prostate Cancer: Findings from a U.K.-Wide Mixed Methods Study

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