Optimal strategy for penile rehabilitation after robot-assisted radical prostatectomy based on preoperative erectile function
ABSTRACT Objective To define the optimal penile rehabilitation programme (PRP) based on preoperative Sexual Health Inventory for Men (SHIM) scores after robot-assisted radical prostatectomy (RARP). Patients and Methods The medical records of 203 patients who underwent bilateral nerve-sparing RARP between 2007 and 2011 were reviewed for the present retrospective study. According to patients' preoperative erection status, group 1 (SHIM = 8-16), group 2 (SHIM = 17-21) and group 3 (SHIM = 22-25) were defined. After bilateral nerve-sparing RARP, phosphodiesterase-5 inhibitors (PDE5Is), a vacuum erection device (VED), the combination of PDE5Is and a VED, or none of them were utilized by all patients for penile rehabilitation. Treatment success was defined as a rigid erection suitable for successful sexual intercourse. Results The numbers of patients in groups 1, 2 and 3, respectively, were 9, 22 and 73, and the mean erectile function recovery periods (EFRPs) were 15.44 +/- 7.73, 12.31 +/- 8.12 and 8.73 +/- 5.67 months (P < 0.05). Group 3 offered the best results for EFRP. Only PDE5Is or the combination of PDE5Is and VED use had a beneficial effect on EFRP (P < 0.05). Using PDE5Is and VED together provided the best result, but there was no difference between PDE5Is and a VED (P > 0.05). Conclusions After bilateral nerve-sparing RARP, PRP with PDE5Is, including the combination of PDE5Is and VED, has a beneficial effect on erectile function recovery across all levels of baseline erectile function. Further large randomized control studies are needed to validate these findings.
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- "The current study showed a statistical and clinical improvement in the sexual function for the participants and such results are in agreement with those gained by Basal et al.  and Elshamy et al. . The improvement rate among patients was 35% for complete regaining of normal sexual function and 40% informed partial improvement, while 25% informed no change in their sexual function and these results are supported by the work of Ballard . "
ABSTRACT: The prevalence of sexual dysfunction in patients with chronic obstructive pulmonary disease is increased; skeletal muscle impairment is common and important complications of chronic obstructive pulmonary disease and pelvic floor muscle have an important role in sexual activity.12/2014; 1(1). DOI:10.1016/j.ejcdt.2014.12.003
Article: Sexuality and prostate cancer[Show abstract] [Hide abstract]
ABSTRACT: All treatments for prostate cancer have a negative impact on sexuality. The objective of this review is to highlight recent developments in the management of sexual dysfunction associated with prostate cancer. We performed a literature search in the Pubmed database to select relevant articles. There is a specific profile of changes in the fields of sexual, urinary, bowel and general quality of life, according to the treatment modalities chosen. Maintenance of a satisfying sex life is a major concern of a majority of men facing prostate cancer and its treatments. It is essential to assess the couple's sexuality before treating prostate cancer in order to deliver comprehensive information and consider early therapeutic solutions adapted to the couple's expectations. The results of randomized studies show that robotic radical prostatectomy allows a faster recovery of natural erections compared to classic laparoscopy. Active pharmacological erectile rehabilitation (intracavernous injections or phosphodiesterase type 5 inhibitors [PDE5i] on demand, during the month following surgery) or passive (daily PDE5i after surgery) might improve the quality of erections especially in response to PDE5i. Unimpaired aspects of sexual response (orgasm) may, when the erection is not yet recovered, represent an alternative allowing the couple to preserve intimacy and complicity. Androgen blockade is a major barrier to maintain or return to a satisfying sex. After the treatment of prostate cancer, one specific support sometimes assisted by networking will optimize satisfying sex life recovery.Progrès en Urologie 07/2013; 23(9):696-711. DOI:10.1016/j.purol.2013.03.011 · 0.77 Impact Factor
- Current problems in cancer 11/2013; 37(6):319-352. DOI:10.1016/j.currproblcancer.2013.10.009 · 1.00 Impact Factor