PURPOSE: Radiation therapy (RT) for prostate cancer is commonly associated with erectile dysfunction (ED), although high-quality data on incidence of ED after brachytherapy (BT) are limited. We reviewed the literature on BT-related ED and propose a clinical pathway for maximal preservation of erectile function (EF) after treatment. METHODS AND MATERIALS: Erectile physiology and pathophysiology after RT are reviewed. Evidence and rationale for the concept of penile rehabilitation are presented. BT literature that focuses on ED is identified. A clinical care pathway for maximally preserving EF in patients treated with RT for localized prostate cancer is proposed. RESULTS: The mechanisms contributing to ED after prostate irradiation involve injury to the neurovascular bundles, penile vasculature, and cavernosal structural tissue. Reported rates of ED after BT vary widely. Basic science and clinical studies support the concept of a structured program of erectile tissue preservation for optimizing EF after radical prostatectomy and are adapted for the prostate radiation patient. CONCLUSIONS: Although definitive evidence for such erectile tissue preservation strategies is pending, there is a solid scientific rationale for the application of available strategies to the radiation patient. Copyright Â
PURPOSE: Radiation therapy (RT) for prostate cancer is commonly associated with erectile dysfunction (ED), although high-quality data on incidence of ED after brachytherapy (BT) are limited. We reviewed the literature on BT-related ED and propose a clinical pathway for maximal preservation of erectile function (EF) after treatment. METHODS AND MATERIALS: Erectile physiology and pathophysiology after RT are reviewed. Evidence and rationale for the concept of penile rehabilitation are presented. BT literature that focuses on ED is identified. A clinical care pathway for maximally preserving EF in patients treated with RT for localized prostate cancer is proposed. RESULTS: The mechanisms contributing to ED after prostate irradiation involve injury to the neurovascular bundles, penile vasculature, and cavernosal structural tissue. Reported rates of ED after BT vary widely. Basic science and clinical studies support the concept of a structured program of erectile tissue preservation for optimizing EF after radical prostatectomy and are adapted for the prostate radiation patient. CONCLUSIONS: Although definitive evidence for such erectile tissue preservation strategies is pending, there is a solid scientific rationale for the application of available strategies to the radiation patient. Copyright Â
Authors: G Gandaglia; G Lista; N Fossati; N Suardi; A Gallina; M Moschini; L Bianchi; M S Rossi; R Schiavina; S F Shariat; A Salonia; F Montorsi; A Briganti Journal: Prostate Cancer Prostatic Dis Date: 2016-02-09 Impact factor: 5.554
Authors: Shari B Goldfarb; Emily Abramsohn; Barbara L Andersen; Shirley R Baron; Jeanne Carter; Maura Dickler; Judith Florendo; Leslie Freeman; Katherine Githens; David Kushner; Jennifer A Makelarski; S Diane Yamada; Stacy Tessler Lindau Journal: J Sex Med Date: 2013-02 Impact factor: 3.802
Authors: I D White; J Wilson; P Aslet; A B Baxter; A Birtle; B Challacombe; J Coe; L Grover; H Payne; S Russell; V Sangar; N Van As; M Kirby Journal: Int J Clin Pract Date: 2014-10-06 Impact factor: 2.503