REHABILITATION OF ERECTILE DYSFUNCTION FOLLOWING RADICAL PROSTATECTOMY

Czech version

Authors: MUDr. Azat Khamzin, CSc.; Prof. MUDr. Dalibor Pacík, CSc.
Authors‘ workplace: Urologická klinika LF MU a FN Brno
Published in: Urol List 2007; 5(3): 54-57

Overview

The incidence of prostate carcinoma is growing worldwide and the disease is ever more often diagnosed in relatively young men with higher demands on the quality of life. Radical prostatectomy is the most frequent standard curative option for a localised carcinoma of the prostate. This treatment option is often accompanied with complications, mostly with sexual function disorders, among which also erectile dysfunction. A number of studies are available today analysing different methods of penile rehabilitation: PDE 5 inhibitor application, vacuum devices, intracavernous or transurethral administration of vasodilating agents. There are also numerous studies providing information on the advantages of an active approach to this issue. A universal strategy for the rehabilitation of erectile function has not yet been discovered, and the existing approach is based on an early use of erectile agents on a regular basis. It is important to discuss the above fact with the patient prior to surgery and the patient should be encouraged to chose suitable treatment strategy following the surgery.

Key words:
prostate carcinoma, radical prostatectomy, erectile dysfunction

Sources

1. Brock G, Nehra A, Lipshultz L et al. Safety and efficacy of vardenafil for the treatment of men with erectile dysfunction after radical retropubic prostatectomy. J Urol 2003;.170: 1278-1283.

2. Carrier S, Zvara P, Nunes L et al. Regeneration of nitric oxide synthase-containing nerves after cavernous nerve neurotomy in the rat. J Urol 1995; 153: 1722.

3. Cookson MS, Nadig PW. Long term results with vacuum constriction device. J Urol 1993; 149: 290-294.

4. Costabile RA, Spevak M, Fishman IJ et al. Efficacy and safety of transurethral alprostadil in patients with erectile dysfunction following radical prostatectomy. J Urol 1998; 160: 1325-1328.

5. Dennis RL, McDougal WS. Pharmacological treatment of erectile dysfunction after radical prostatectomy. J Urol 1988; 139: 775-776.

6. Desouza C, Parulkar A, Lumpkin D et al. Acute and prolonged effects of sildenafil on brachial artery flow-mediated dilatation in type 2 diabetes. Diabetes Care 2002; 25: 1336-1339.

7. Diederichs W, Kaula NF, Lue TF, Tanagho EA. The effect of subatmospheric pressure on the simian penis. J Urol 1989; 142: 1087-1089.

8. Evans C. Complications of intracavernosal therapy for impotence. In: Carson C, Kirby R, Goldstein I (eds). Textbook ofErectile Dysfunction. Oxford: Isis Medical Media 1999: 365-370.

9. Gontero P, Fontana F, Bagnasacco A et al. Is there an optimal time for intracavernous prostaglandin E1 rehabilitation following nonnerve sparing radical prostatectomy? Results from a hemodynamic prospective study. J Urol 2003; 169: 2166-2169.

10. Hong EK, Lepor H, McCullough AR. Time dependent patient satisfaction with sildenafil for erectile dysfunction (ED) after nerve-sparing radical retropubic prostatectomy (RRP). Int J Impot Res 1999; 11(suppl 1): S15-S22.

11. Hsing AW, Tsao L, Devesa SS. International trends and patterns of prostate cancer incidence and mortality. Int J Cancer 2000; 85: 60-67.

12. Katz SD, Balidemaj K, Homma S et al. Acute type 5 phosphodiesterase inhibition with sildenafil enhances flow-mediated vasodilation in patients with chronic heart failure. J Am Coll Cardiol 2000; 36: 845-851.

13. Katz SD. Potential role of type 5 phosphodiesterase inhibition in the treatment of congestive heart failure. Congest Heart Fail 2003; 9: 9-15.

14. Kendirci M, Hellstrom WJ. Current concepts in the management of erectile dysfunction in men with prostate cancer. Clin Prostate Cancer 2004; 3: 87-92.

15. McCullough AR. Management of erectile dysfunction following radical prostatectomy. Sex Dysf Med 2000; 2: 2-9.

16. McCullough A, Woo K, Telegrafi S, Lepor H. Is sildenafil failure in men after radical retropubic prostatectomy (RRP) due to arterial disease? Penile duplex Doppler findings in 174 men after RRP. Int J Impot Res 2002; 14: 462-465.

17. Lowentritt BH, Scardino PT, Miles BJ et al. Sildenafil citrate after radical retropubic prostatectomy. J Urol 1999; 162: 1614-1617.

18. Montorsi F, Guazzoni G, Strambi L et al. Recovery of spontaneous erectile function after nerve-sparing radical retropubic prostatectomy with and without early intracavernous injections of alprostadil: results of a prospective, randomized trial. J Urol 1997; 158: 1408-1410.

19. Montorsi F, Maga T, Strambi LF et al. Sildenafil taken at bedtime significantly increases nocturnal erections: results of a placebo-controlled study. Urology 2000; 56: 906-911.

20. Montorsi F, Nathan H P, McCullough A et al. Tadalafil in the treatment of erectile dysfunction following bilateral nerve sparing radical retropubic prostatectomy: a randomized, double blind, placebo controlled trial. J Urol 2004; 172: 1036-1041.

21. Montorsi F, Briganti A. What's new in erectile dysfunction following radical prostatectomy. AUA News 2005; 10: 9-11.

22. Moon DG, Lee DS, Kim JJ. Altered contractile response of penis under hypoxia with metabolic acidosis. Int J Impot Res 1999; 11: 265-271.

23. Moreland RB. Is there a role of hypoxemia in penile fibrosis: a viewpoint presented to the Society for the Study of Impotence. Int J Impot Res 1998; 10: 113-120.

24. Mulhall JP, Graydon RJ. The hemodynamics of erectile dysfunction following nerve-sparing radical retropubic prostatectomy. Int J Impot Res 1996; 169: 1462-1464.

25. Mulhall JP, Slovick R, Hotaling J et al. Erectile dysfunction after radical prostatectomy: hemodynamic profiles and their correlation with the recovery of erectile function. J Urol 2002; 167: 1371-1375.

26. Mulhall JP, Land S, Parker M et al. The use of an erectogenic pharmacotherapy regimen following radical prostatectomy improves recovery of spontaneous erectile function. J Sex Med 2005; 2: 532-542.

27. Mydlo JH, Viterbo R, Crispen P. Use of combined intracorporal injection and a phosphodiesterase-5 inhibitor therapy for men with a suboptimal response to sildenafil and/or vardenafil monotherapy after radical retropubic prostatectomy. BJU Int 2005; 95: 843-846.

28. Nehra A, Blute ML, Barrett DM et al. Rationale for combination therapy of intraurethral prostaglandin E (1) and sildenafil in the salvage of erectile dysfunction patients desiring noninvasive therapy. Int J Impot Res 2002; 14(suppl 1): S38-S42.

29. Padma-Nathan H, McCullough A, Guiliano F et al. Postoperative nightly administration of sildenafil citrate significantly improves normal spontaneous erectile function after bilateral nerve-sparing radical prostatectomy. J Urol 2003; 169(suppl 4): 375.

30. Penson DF, McLerran D, Feng Z et al. 5-year urinary and sexual outcomes after radical prostatectomy: results from the prostate cancer outcomes study. J Urol 2005; 173: 1701-1705.

31. Rabbani F, Stapleton AM, Kattan MW et al. Factors predicting recovery of erections after radical prostatectomy. J Urol 2000; 164: 1929-1934.

32. Raina R, Agarwal A, Ausmundson S et al. Long-term efficacy and compliance of MUSE for erectile dysfunction following radical prostatectomy. SHIM (IIEF 5) analysis. Int J Impot Res 2005; 17: 86-90.

33. Raina R, Agarwal A, Nandipati KC et al. Interim analysis of the early use of MUSE following radical prostatectomy (RP) to facilitate early sexual activity and return of spontaneous erectile function. J Urol 2005; 173(suppl): 737.

34. Raina R, Agarwal A, Ausmundson S et al. Early use of vacuum constriction device following radical prostatectomy facilitates early sexual activity and potentially earlier return of erectile function. Int J Impot Res 2006; 18: 77-81.

35. Rodriguez VL, Gonzalvo IA, Bono AA et al. Erectile dysfunction after radical prostatectomy. Etiopathology and treatment. Actas Urol Esp 1997; 21: 909-921.

36. Schrader-Bogan CL, Kjellberg JL, McPherson CP et al. Quality of life and treatment outcomes: Prostate carcinoma patients'perspectives after prostatectomy or radiation therapy. Cancer 1997; 79: 1977-1986.

37. Schwartz EJ, Wong P, Graydon RJ. Sildenafil preserves intracorporeal smooth muscle after radical retropubic prostatectomy. J Urol 2004; 171: 771-774.

38. Walsh PC, Marschke P, Ricker D et al. Patient-reported urinary continence and sexual function after anatomic radical prostatectomy. Urology 2000; 55: 58-61.

39. Young HH. The early diagnosis and radical cure of carcinoma of the prostate. Being a study of 40 cases and presentation of a radical operation which was carried out in four cases. 1905. J Urol 2002; 167: 939-947.

40. Zippe CD, Kedia S, Kedia AW et al. Sildenafil citrate (Viagra) after radical retropubic prostatectomy: pro. Urology 1999; 54: 583-586.

41. Zippe CD, Jhaveri FM, Klein EA, Kedia S et al. Role of Viagra after radical prostatectomy. Urology 2000; 55(2): 241-245.