Proerectile pharmacological prophylaxis following nerve-sparing radical prostatectomy (NSRP)

Prostate Cancer and Prostatic Diseases
P Gontero, R Kirby

Abstract

The importance of an early pharmacological prophylaxis for erectile function following nerve-sparing radical prostatectomy has been recently stressed by several authors. In spite of that, patient's compliance to erectile rehabilitation protocols seems to be low. The present review is an attempt to define the expected benefits of the currently proposed rehabilitative protocols in terms of cost-efficiency and quality of life. The conclusion is that current scientific evidence in support of an early postoperative use of erectile aids is based mainly on indirect proof of a cavernosal damage that may follow the temporary postoperative 'erectile silence'. Intracavernosal injections or a vacuum device may represent the best first-line treatment option for the first few months from the procedure as their mechanism of action does not require intact neural tissue for erection. Thereafter oral phosphodiesterase 5 inhibitor therapy may be a reasonable choice for those patients who can achieve at least a partial erection. A phosphodiesterase 5 inhibitor may not be effective when spontaneous erections are absent. It is possible, since the rehabilitation of sexual function aims to prevent cavernosal tissue damage by providing oxygenation to t...Continue Reading

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Citations

Apr 23, 2010·International Journal of Impotence Research·J YuanR Wang
May 13, 2005·International Journal of Impotence Research·L GalloA Gallo
Dec 19, 2007·Asian Journal of Andrology·Andrew R McCullough
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May 10, 2006·The Journal of Sexual Medicine·Linda VignozziMario Maggi
Jun 18, 2011·The Journal of Sexual Medicine·Raanan TalJohn P Mulhall
Apr 5, 2013·The Journal of Sexual Medicine·Haocheng LinRun Wang
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Aug 4, 2006·Cancer Control : Journal of the Moffitt Cancer Center·Alejandro J Miranda-SousaRafael E Carrion

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