Prevention and management of post prostatectomy erectile dysfunction.

摘要: Sexual dysfunction is common in patients with prostate cancer (PC) following radical prostatectomy (RP). Review the available literature concerning prevention and management strategies for post-RP erectile function (EF) impairment terms of preoperative patient characteristics, intra postoperative factors that may influence EF recovery, treatments (ED). A search was performed using Google PubMed database English-language original review articles, either published or e-published up to July 2013. The still demonstrates a great inconsistency definition what considered normal both before after RP. Thus, validated psychometric instruments recognized cut-offs normalcy severity during pre- post-operative evaluation should be routinely considered. Therefore, comprehensive discussion about true prevalence ED, concept spontaneous pharmacologically-assisted erections, difference between “back baseline” “erections adequate enough have successful intercourse” clearly emerge as key issues eventual understanding ED promotion satisfactory recovery. Patient (including age, baseline EF, comorbid conditions status), selection (non- vs. uni- bilateral nerve-sparing), type surgery (i.e., inter extrafascial surgeries), surgical techniques open, laparoscopic robotically-assisted RP), surgeon volume skill) represent significant contributors number preclinical clinical data show rehabilitation treatment due time are undoubtedly better than leaving tissue its unassisted fate. role those who received non-nerve-sparing RP also extensively discussed. Optimal outcomes achieved mainly by careful choice correct surgery. Despite plethora potential rehabilitative approaches, they only “strategies”, since incontrovertible evidence their effectiveness improving natural recovery limited. Conversely, numerous effective therapeutic options treating ED.