| Prevention and Management of Postprostatectomy Sexual Dysfunctions Part 2: Recovery and Preservation of Erectile Function, Sexual Desire, and Orgasmic Function. | |
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MedLine Citation:
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PMID: 22575910 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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. |
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Authors:
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Andrea Salonia; Arthur L Burnett; Markus Graefen; Kostas Hatzimouratidis; Francesco Montorsi; John P Mulhall; Christian Stief |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-5-3 |
Journal Detail:
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Title: European urology Volume: - ISSN: 1873-7560 ISO Abbreviation: - Publication Date: 2012 May |
Date Detail:
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Created Date: 2012-5-11 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7512719 Medline TA: Eur Urol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved. |
Affiliation:
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Department of Urology, University Vita-Salute San Raffaele, Milan, Italy. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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