Title:Penile Rehabilitation After Radical Prostatectomy
Volume: 16
Issue: 5
Author(s): David Jacques Cohen and Sidney Glina
Affiliation:
Keywords:
Erectile dysfunction, penis erection, prostatectomy, penile function, phosphodiesterase type 5 inhibitors, prostate
cancer, rehabilitation.
Abstract: Erectile dysfunction (ED) is the main and most frequent side effect after radical prostatectomy.
Also, ED is the primary impact factor for quality of life after radical prostatectomy. ED post
radical prostatectomy is mainly due to lesions in the neurovascular bundles which can occur by partial
or total sectioning, by stretching (the most common), or by thermal lesion of the nervous fibers, leading
to a condition called “neuropraxia”. The term penile rehabilitation (PR) after prostatectomy has
been defined as any intervention with the intent of reestablishing preoperative erectile function and includes
the isolated or combined use of phosphodiesterase 5 inhibitors (PDE5i), intracavernous injection,
vacuum erectile device therapy, and use of intraurethral drugs. The use of intracavernous drugs,
of intraurethral prostaglandin and the use of vacuum therapy have a poorly defined role regarding postoperative penile rehabilitation
and must be better investigated through further studies. The use of PDE5i as PR is strongly supported by experimental
research, but most clinical trials found controversial results.
