| Erectile dysfunction following prostatectomy: prevention and treatment. | |
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MedLine Citation:
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PMID: 19657376 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Radical prostatectomy (RP) remains the standard treatment for men with clinically localized prostate cancer, despite the range of alternative treatment modalities. Even with significant advances in surgical technique and superb results for cancer control and preservation of urinary function, erectile dysfunction (ED) following RP is a common complication. This is mainly attributed to temporary cavernous nerve damage (neuropraxia) resulting in penile hypoxia, smooth muscle apoptosis, fibrosis and veno-occlusive dysfunction. One of the most promising new approaches is the concept of early penile rehabilitation, which is thought to prevent ED after RP by countering post-RP pathophysiological changes during the period of neural recovery. Various treatments, such as vacuum constriction devices, intraurethral and intracorporal alprostadil, and phosphodiesterase type 5 (PDE5) inhibitors, might serve to facilitate recovery of erectile function. PDE5 inhibitors are considered as the first-line treatment for early penile rehabilitation, with superior erectile function outcomes compared to placebo. Definitive conclusions regarding the success of penile rehabilitation cannot be drawn at this time because of differences in study design, data acquisition, and definitions of potency. Continued prospective, rigorous study is needed to develop and bring forward this important field and to establish the best evidence basis for counseling and treating patients suffering from ED after RP. |
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Authors:
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Ahmed Magheli; Arthur L Burnett |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Nature reviews. Urology Volume: 6 ISSN: 1759-4820 ISO Abbreviation: Nat Rev Urol Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-08-06 Completed Date: 2010-04-19 Revised Date: 2011-07-19 |
Medline Journal Info:
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Nlm Unique ID: 101500082 Medline TA: Nat Rev Urol Country: England |
Other Details:
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Languages: eng Pagination: 415-27 Citation Subset: IM |
Affiliation:
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Department of Urology, Charité University Medicine Berlin, Berlin, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Erectile Dysfunction
/
etiology,
prevention & control*,
therapy* Humans Male Phosphodiesterase 5 Inhibitors Phosphodiesterase Inhibitors / pharmacology, therapeutic use Prostatectomy / adverse effects* Prostatic Neoplasms / physiopathology, surgery Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Phosphodiesterase 5 Inhibitors; 0/Phosphodiesterase Inhibitors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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