Erectile dysfunction after radical prostatectomy

Abstract

Purpose of review This review will discuss erectile dysfunction (ED) in prostate cancer patients following radical prostatectomy (RP). It will focus on the prevalence and current treatments for ED as well as the emotional impact of ED and the current psychosocial interventions designed to help patients cope with this side effect. Recent findings While there is a large discrepancy in prevalence rates of ED after RP, several recent studies have cited rates as high as 85%. The concept of “penile rehabilitation” is now the standard of practice to treat ED following RP. However, many men avoid seeking help or utilizing ED treatments. This avoidance is related to the shame, frustration, and distress many men with ED and their partners experience. Recent psychosocial interventions have been developed to facilitate the use of treatments and help men cope with ED. These interventions have shown initial promise, however, continued intervention development is needed to reduce distress and improve long-term erectile function (EF) outcomes. Summary ED is a significant problem following prostate cancer surgery. While there are effective medical treatments, the development of psychosocial interventions should continue to evolve to maximize the assistance we can give to men and their partners.

Impact of urinary incontinence on the quality of life of individuals undergoing radical prostatectomy

“…Researchers have identified that surgery negatively affects sexual function causing a significant impact in the social domain regarding the evaluation of post-RP QoL 15 . Another study also reinforces this finding by pointing out that the impact on erectile dysfunction goes beyond the physical aspect and affects psychological and relationship aspects 20 .…”

The Use of Vasoactive Drugs in the Treatment of Male Erectile Dysfunction: Current Concepts

“…In various randomized, multicenter, prospective trials, in comparison to placebo, PDE5 inhibitors significantly improved all primary endpoints in patients coping with this side effect of surgical intervention for prostate cancer. Since, under conditions of sexual stimulation, the pro-erectile effects of PDE5 inhibitors are dependent upon the unimpaired function of cavernous nerves (releasing the gaseous neurotransmitter NO) innervating the vascular and non-vascular penile smooth musculature, the treatment effect is mediocre to poor in patients who had undergone non-nerve sparing pelvic surgeries [15]. This is well in accordance with the results from a recent meta-analysis indicating that the placebo effect shows a tendency to be much more pronounced among subjects with ED associated with post-traumatic stress disorder (for example, following pelvic/prostatectomy surgery) with almost no significant differences between the treatment effects exerted by placebo and PDE5 inhibitors [16].…”

IcarisideII facilitates the differentiation of ADSCs to SCs via let-7i/STAT3 axis to preserve erectile function

“…Prostate cancer is the second leading cause of cancer-related death in men worldwide [1, 2]. Erectile dysfunction (ED) administered by injury of cavernous nerve is a significant problem following prostate cancer surgery, which seriously affects the quality of life of patients [3–5]. Adipose tissue-derived stem cells (ADSCs) has significant treatment effect for ED in diabetics, post-prostatectomy patients, and those with peyronie’s disease [6, 7].…”