scholarly journals Prevention and managment possibilities of erectile dysfunction after radical prostatectomy

2009 ◽  
Vol 150 (18) ◽  
pp. 831-837
Author(s):  
Péter Riesz ◽  
András Rusz ◽  
Miklós Szűcs ◽  
Attila Majoros ◽  
Péter Nyírády ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Erectile Dysfunction ◽  
Radical Prostatectomy ◽  
Early Stage ◽  
Sexual Life ◽  
Nerve Sparing ◽  
Non Invasive ◽  
Younger Age ◽  
Detect Prostate Cancer

Radical prostatectomy is the curative surgical management of organ confined prostate cancer. Erectile dysfunction may follow surgery as the most common complication decreasing the quality of life of the patient. Thanks to spreading PSA screening probabilty increases to detect prostate cancer in its early stage and so the expected number of surgery is increasing, too. Higher number of operation as well as surgery more frequently performed in younger age calls the attention to the importance of erectile dysfunction and its management. Nowadays the physiology of erectile dysfunction due to radical prostatectomy has been revealed, and as a consequence, the nerve sparing surgery for its prevention is already known. The paper presents the different kind of possible invasive and non-invasive treatments of erectile dysfunction, and surveys their history and effectiveness. The erectile function of patients who underwent radical prostatectomy between 1998 and 2007 at the Department of Urology and Urooncological Centre was assessed by IIEF- and MMM questionnaire and letters with questions of habit of medicine taking. The results showe that 59% of patients who require sexual life are capable of it spontaneously or with medical management.

Quality of life after brachytherapy or bilateral nerve-sparing robot-assisted radical prostatectomy for prostate cancer: a prospective cohort

2017 ◽  
Vol 121 (4) ◽  
pp. 540-548 ◽  
Author(s):  
Pierre Blanchard ◽  
John W. Davis ◽  
Steven J. Frank ◽  
Jeri Kim ◽  
Curtis A. Pettaway ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Prospective Cohort ◽  
Nerve Sparing ◽  
Robot Assisted

scholarly journals Incontinence and Erectile Dysfunction Following Radical Prostatectomy: A Review

2005 ◽  
Vol 5 ◽  
pp. 747-758 ◽  
Author(s):  
Gerasimos Alivizatos ◽  
Andreas Skolarikos
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Erectile Dysfunction ◽  
Radical Prostatectomy ◽  
Surgical Technique ◽  
Localized Prostate Cancer ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Radical prostatectomy remains the treatment of choice for localized prostate cancer in age-appropriate and health-appropriate men. Although cancer control is the most important aspect of a radical prostatectomy, minimization of postoperative morbidity, especially urinary incontinence and erectile dysfunction, is becoming a greater concern. We reviewed recent data available on Medline regarding the incidence, pathophysiology, evaluation, and treatment of incontinence and sexual dysfunction after radical prostatectomy. Health-related quality of life issues have been specifically addressed. Although low incidences of incontinence and erectile dysfunction after radical prostatectomy have been reported in the hands of experienced surgeons, the literature review revealed a great variety, with incontinence rates ranging from 0.3–65.6% and potency rates ranging from 11–87%. Several factors contribute to this wide difference, the most important being the application of a meticulous surgical technique. General and cancer-specific health-related quality of life is not being affected after radical prostatectomy. The incidence of incontinence and erectile dysfunction is higher after radical prostatectomy when compared to the incidence observed when other therapies for localized prostate cancer are applied. However, the majority of the patients undergoing radical prostatectomy would vote for the operation again. Today, avoidance of major complications after radical prostatectomy depends mostly on a high-quality surgical technique. When incontinence or erectile dysfunction persists after radical prostatectomy, the majority of the treated patients can be managed effectively by various methods.

Topical alprostadil (Vitaros©) in the treatment of erectile dysfunction after non-nerve-sparing robot-assisted radical prostatectomy

2017 ◽  
Vol 85 (2) ◽  
pp. 55-59 ◽  
Author(s):  
Pier Andrea Della Camera ◽  
Simone Morselli ◽  
Gianmartin Cito ◽  
Giovanni Tasso ◽  
Nicola Laruccia ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Radical Prostatectomy ◽  
Sexual Intercourse ◽  
Performance Status ◽  
Eastern Cooperative Oncology Group ◽  
Nerve Sparing ◽  
Robot Assisted ◽  
Ecog Performance Status ◽  
Comorbidity Index

Objective: The aim of the study is the evaluation of the efficacy and safety of the treatment with topical alprostadil (Vitaros©) in post-robot assisted radical prostatectomy (RARP) rehabilitation therapy of patients with erectile dysfunction (ED). Methods: Seventy-four patients were enrolled and underwent non-nerve-sparing RARP. Inclusion criteria: age <75, preoperatively International Index of Erectile Function (IIEF-5) >16, erection hardness score (EHS) ⩾2, weekly sexual intercourse ⩾1, affirmative answers to Sexual Encounter Profile Question (SEP-Q) 2 and SEP-Q3, Charlson Comorbidity Index (CCI) ⩽5, Eastern Cooperative Oncology Group (ECOG) performance status ⩽1, no moderate/severe cardiovascular disease. Results: Vitaros was administered ⩾2 twice a week. At month 6, the IIEF-5 decreased from 20.5 preoperative to 18.1 post-treatment. EHS score decreased from a mean of 3.3 to a mean of 3.0. The quality of life score decreased from an average of 5.1 to 2.3. Weekly sexual intercourse decreased from an average of 2.1 to 1.7. Six patients dropped out; 89.7% patients showed a positive SEP-Q2 and 77.8% a positive SEP-Q3. All patients responded positively to Global Assessment Questions (GAQ)-1 and 97% to GAQ-2. Of all 68 analyzed patients, 13 (17.6%) switched to intracavernous injection therapy. Conclusions: In conclusion, Vitaros may become a viable alternative to common injective therapies in well-selected patients after RARP.

scholarly journals Anatomy of the neurovascular bundle and methods of its preservation with nerve-sparing prostatectomy

2018 ◽  
Vol 5 (3) ◽  
pp. 53-66
Author(s):  
H. S. Gevorgyan ◽  
A. A. Kostin ◽  
N. V. Vorobyev ◽  
K. М. Nyushko ◽  
A. G. Muradyan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Prostate Gland ◽  
Neurovascular Bundle ◽  
Diagnostic Methods ◽  
High Tech ◽  
Nerve Sparing ◽  
High Quality

Providing a high quality of life for a man after performing radical prostatectomy for prostate cancer is currently one of the topical problems of urology and andrology. Nervous-protective radical prostatectomy is one of the high-tech operations in urology and the surgeon’s task is not only to remove the tumor of the prostate gland, but also to ensure a high quality of life for the patient. The importance and urgency of this problem is evidenced by the fact that most of the issues that arise in patients in conversation with a surgeon before surgical intervention are devoted to it.The National Institute of Health of the USA shows that the incidence of prostate cancer is about 9.5% per year, and the localized form began to occur in younger men. In this regard, the surgeon faces the task not only to cure the patient of malignant education, but also to maintain the erectile function and the continent’s indicators, thereby improving the quality of life.At the present stage, diagnostic methods make it possible to detect early prostate cancer much more often, so that the identification and treatment of such patients become more accessible and allows the use of this operation. However, for the preservation of the neurovascular bundle, it is mandatory to know the anatomical features of this zone.Over the past few decades, anatomical studies have been conducted that described the neuroanatomy of the prostate and the adjacent tissue. This article summarizes the latest results of studies of neuroanatomical studies, some of which contradict the established consensus on pelvic anatomy.

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