After Radical Prostatectomy: Erectile Dysfunction Diagnosis and Its Treatment - A Literature Review
DOI:
https://doi.org/10.12775/QS.2024.35.56335Keywords
Prostate cancer, Radical prostatectomy, Erectile dysfunctionAbstract
Introduction and purpose of work:
In the last 10 years, prostate cancer has become the most common cancer in the Polish population of men with the high growth dynamics. Despite the fact that we are getting better with mortality and new surgery techniques, complications in the form of urinary incontinence and erectile dysfunctions after radical prostatectomy are a common problem. This study deals with the second problem, often underestimated by the society, but equally important in maintaining high -quality life. Our goal is to present aethiology, diagnostics and treating patients with erectile dysfunction after radical prostatectomy due to prostate cancer. It can help doctors who usually do not have contact with such patients, understand the problem and manage effective treatment in their daily practice.
Method:
We searched for studies and articles via PubMed using the keywords prostate cancer, radical prostatectomy, erectile dysfunction. From screened documents identified from literature search, 52 articles were included in our review.
Summary:
Erection dysfunction is a complex problem, in which the basis is the interaction of the vascular and nervous systems. To diagnose the patient, you need to conduct a thorough interview, generally about medical history and chronic diseases, but also about sex life. After the diagnosis, there are many treatment options to choose from, pharmacological and non-pharmacological. An important aspect of treatment that you cannot forget is psychological support which should start from the moment of diagnosis of prostate cancer. Each method has pros and cons, but effective cooperation with the patient will give the desired results.
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Tadalafil On Demand in Clinical Subgroups of Men With Erectile Dysfunction: A Descriptive
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doi:10.1016/j.jsxm.2016.02.171
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erectile dysfunction after non-nerve-sparing robot-assisted radical prostatectomy. Urologia.
;85(2):55-59. doi:10.5301/uj.5000267
Raina R, Pahlajani G, Agarwal A, Zippe CD. The early use of transurethral alprostadil after
radical prostatectomy potentially facilitates an earlier return of erectile function and successful
sexual activity. BJU Int. 2007;100(6):1317-1321. doi:10.1111/j.1464-410X.2007.07124.x
Moncada I, Martinez-Salamanca J, Ruiz-Castañe E, Romero J. Combination therapy for erectile
dysfunction involving a PDE5 inhibitor and alprostadil. Int J Impot Res. 2018;30(5):203-208.
doi:10.1038/s41443-018-0046-2
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(1):77-81. doi:10.1038/sj.ijir.3901380
Sridhar AN, Cathcart PJ, Yap T, et al. Recovery of Baseline Erectile Function in Men Following
Radical Prostatectomy for High-Risk Prostate Cancer: A Prospective Analysis Using Validated
Measures. J Sex Med. 2016;13(3):435-443. doi:10.1016/j.jsxm.2016.01.005
Walker LM. Psychosocial contributors to patients’ and partners’ postprostate cancer sexual
recovery: 10 evidence-based and practical considerations. Int. J Impot. Res. 2021; 33: 464–472
Walker LM, Wassersug RJ, Robinson JW. Psychosocial perspectives on sexual recovery after
prostate cancer treatment. Nat Rev Urol. 2015;12(3):167-176. doi:10.1038/nrurol.2015.29
Gong B, Ma M, Xie W, et al. Direct comparison of tadalafil with sildenafil for the treatment of
erectile dysfunction: a systematic review and meta-analysis. Int Urol Nephrol.
;49(10):1731-1740. doi:10.1007/s11255-017-1644-5
Mulhall JP, Brock G, Oelke M, et al. Effects of Tadalafil Once-Daily or On-Demand vs Placebo
on Return to Baseline Erectile Function After Bilateral Nerve-Sparing Radical Prostatectomy--
Results from a Randomized Controlled Trial (REACTT). J Sex Med. 2016;13(4):679-683.
doi:10.1016/j.jsxm.2016.01.022
Brock G, Montorsi F, Costa P, et al. Effect of Tadalafil Once Daily on Penile Length Loss and
Morning Erections in Patients After Bilateral Nerve-sparing Radical Prostatectomy: Results
From a Randomized Controlled Trial. Urology. 2015;85(5):1090-1096. doi:10.1016/
j.urology.2014.11.058
Montorsi F, Brock G, Stolzenburg JU, et al. Effects of tadalafil treatment on erectile function
recovery following bilateral nerve-sparing radical prostatectomy: a randomised placebocontrolled
study (REACTT). Eur Urol. 2014;65(3):587-596. doi:10.1016/j.eururo.2013.09.051
Burns PR, Rosen RC, Dunn M, Baygani SK, Perelman MA. Treatment satisfaction of men and
partners following switch from on-demand phosphodiesterase type 5 inhibitor therapy to
tadalafil 5 mg once daily. J Sex Med. 2015;12(3):720-727. doi:10.1111/jsm.12818
Brock G, Ni X, Oelke M, et al. Efficacy of Continuous Dosing of Tadalafil Once Daily vs
Tadalafil On Demand in Clinical Subgroups of Men With Erectile Dysfunction: A Descriptive
Comparison Using the Integrated Tadalafil Databases. J Sex Med. 2016;13(5):860-875.
doi:10.1016/j.jsxm.2016.02.171
Nelson CJ, Scardino PT, Eastham JA, Mulhall JP. Back to baseline: erectile function recovery
after radical prostatectomy from the patients' perspective. J Sex Med. 2013;10(6):1636-1643.
doi:10.1111/jsm.12135
Morrisette MJ, Dunn SP. Phosphodiesterase Type 5 Inhibitors and Oral Nitrates in Male Patients
with Ischemic Heart Disease. Curr Cardiol Rep. 2023;25(6):553-560. doi:10.1007/
s11886-023-01873-y
Eardley I, Donatucci C, Corbin J, et al. Pharmacotherapy for erectile dysfunction. J Sex Med.
;7(1 Pt 2):524-540. doi:10.1111/j.1743-6109.2009.01627.x
Porst H, Burnett A, Brock G, et al. SOP conservative (medical and mechanical) treatment of
erectile dysfunction. J Sex Med. 2013;10(1):130-171. doi:10.1111/jsm.12023
Dinsmore WW, Wyllie MG. Vasoactive intestinal polypeptide/phentolamine for intracavernosal
injection in erectile dysfunction. BJU Int. 2008;102(8):933-937. doi:10.1111/
j.1464-410X.2008.07764.x
Gromicho A, Costa P, Araújo D, Pereira D, Ferraz L. Sexual rehabilitation with intracavernous
alprostadil after radical prostatectomy: Outcomes from a nursing program. Arch Ital Urol
Androl. 2021;93(4):404-407. Published 2021 Dec 20. doi:10.4081/aiua.2021.4.404
Della Camera PA, Morselli S, Cito G, et al. Topical alprostadil (Vitaros©) in the treatment of
erectile dysfunction after non-nerve-sparing robot-assisted radical prostatectomy. Urologia.
;85(2):55-59. doi:10.5301/uj.5000267
Raina R, Pahlajani G, Agarwal A, Zippe CD. The early use of transurethral alprostadil after
radical prostatectomy potentially facilitates an earlier return of erectile function and successful
sexual activity. BJU Int. 2007;100(6):1317-1321. doi:10.1111/j.1464-410X.2007.07124.x
Moncada I, Martinez-Salamanca J, Ruiz-Castañe E, Romero J. Combination therapy for erectile
dysfunction involving a PDE5 inhibitor and alprostadil. Int J Impot Res. 2018;30(5):203-208.
doi:10.1038/s41443-018-0046-2
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(1):77-81. doi:10.1038/sj.ijir.3901380
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Copyright (c) 2024 Kinga Pakos, Krzysztof Górczyński, Kornel Majewski, Aleksandra Majewska, Maria Czujkowska, Jan Kowalewski, Grzegorz Pyc, Kamila Durmała, Zuzanna Bałoniak, Jakub Mączka
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