CONTEXT: Sexual dysfunction is common in patients who undergo radical prostatectomy (RP) for prostate cancer (PCa). OBJECTIVE: Review the available literature concerning prevention of, and management strategies for, post-RP sexual dysfunction in terms of postoperative treatments for erectile function (EF), sexual desire (SD), and orgasmic function (OF) impairment. EVIDENCE ACQUISITION: A literature search was performed using Google and PubMed databases for English language original and review articles either published or e-published up to November 2011. EVIDENCE SYNTHESIS: We propose a rational description of many of the clinically available preventive and therapeutic strategies for the preservation and recovery of post-RP EF. A huge amount of preclinical data show that tissue damage ultimately leads to structural alterations, and the literature stresses that rehabilitation and treatment are undoubtedly better than leaving the erectile tissue to its unassisted fate; likewise, the timing of any rehabilitation and treatment is of major clinical importance. However, no specific recommendation emerges regarding the structure of the optimal rehabilitation or treatment regimen. The role of postoperative erectile dysfunction (ED) treatment of those patients who received a non-nerve-sparing RP was also extensively discussed. The literature almost completely lacks a systematic and comprehensive debate about SD (ie, low libido) and OF (ie, decreased intensity of orgasm, dysorgasmia, and climacturia) in patients undergoing RP. Psychological and sexual counseling is of major importance to improve any rehabilitation and treatment of postoperative EF, SD, and OF impairment. CONCLUSIONS: Despite the great number of possible rehabilitation approaches proposed, these approaches should be considered only as strategies, since incontrovertible evidence of their effectiveness for improving natural EF recovery is limited. Conversely, numerous effective therapeutic options are available for treating post-RP ED. SD and OF have not yet been fully assessed in patients who underwent RP.
CONTEXT: Sexual dysfunction is common in patients who undergo radical prostatectomy (RP) for prostate cancer (PCa). OBJECTIVE: Review the available literature concerning prevention of, and management strategies for, post-RP sexual dysfunction in terms of postoperative treatments for erectile function (EF), sexual desire (SD), and orgasmic function (OF) impairment. EVIDENCE ACQUISITION: A literature search was performed using Google and PubMed databases for English language original and review articles either published or e-published up to November 2011. EVIDENCE SYNTHESIS: We propose a rational description of many of the clinically available preventive and therapeutic strategies for the preservation and recovery of post-RP EF. A huge amount of preclinical data show that tissue damage ultimately leads to structural alterations, and the literature stresses that rehabilitation and treatment are undoubtedly better than leaving the erectile tissue to its unassisted fate; likewise, the timing of any rehabilitation and treatment is of major clinical importance. However, no specific recommendation emerges regarding the structure of the optimal rehabilitation or treatment regimen. The role of postoperative erectile dysfunction (ED) treatment of those patients who received a non-nerve-sparing RP was also extensively discussed. The literature almost completely lacks a systematic and comprehensive debate about SD (ie, low libido) and OF (ie, decreased intensity of orgasm, dysorgasmia, and climacturia) in patients undergoing RP. Psychological and sexual counseling is of major importance to improve any rehabilitation and treatment of postoperative EF, SD, and OF impairment. CONCLUSIONS: Despite the great number of possible rehabilitation approaches proposed, these approaches should be considered only as strategies, since incontrovertible evidence of their effectiveness for improving natural EF recovery is limited. Conversely, numerous effective therapeutic options are available for treating post-RP ED. SD and OF have not yet been fully assessed in patients who underwent RP.
Authors: Dean S Elterman; Anika R Petrella; Lauren M Walker; Brandon Van Asseldonk; Leah Jamnicky; Gerald B Brock; Stacy Elliott; Antonio Finelli; Jerzy B Gajewski; Keith A Jarvi; John Robinson; Janet Ellis; Shaun Shepherd; Hossein Saadat; Andrew Matthew Journal: Can Urol Assoc J Date: 2018-12-03 Impact factor: 1.862
Authors: Carlo Andrea Bravi; Amy Tin; Francesco Montorsi; John P Mulhall; James A Eastham; Andrew J Vickers Journal: J Sex Med Date: 2019-11-15 Impact factor: 3.802
Authors: A Matthew; N Lutzky-Cohen; L Jamnicky; K Currie; A Gentile; D Santa Mina; N Fleshner; A Finelli; R Hamilton; G Kulkarni; M Jewett; A Zlotta; J Trachtenberg; Z Yang; D Elterman Journal: Curr Oncol Date: 2018-12-01 Impact factor: 3.677
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