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  • Title: Recovery of sexual function after prostate cancer treatment.
    Author: Donatucci CF, Greenfield JM.
    Journal: Curr Opin Urol; 2006 Nov; 16(6):444-8. PubMed ID: 17053525.
    Abstract:
    PURPOSE OF REVIEW: The estimated disease-free survival rates are approximately equivalent across standard treatments for localized prostate cancer. We aim to review the efforts being made to reduce posttreatment erectile dysfunction, a major morbidity of these therapies. RECENT FINDINGS: Potency as an important factor in a patient's decision about choosing a form of therapy has been demonstrated in the literature. For nerve-sparing surgery, though some proponents of laparoscopic radical prostatectomy believe it may confer an advantage over the open surgical techniques, the published data is scarce and has yet to demonstrate a true difference. Enthusiasm has declined for sural nerve grafting because of the associated complexity of the procedure and inconsistent results. Concurrent implantation of a penile prosthesis is an option for certain patients who already have some baseline erectile dysfunction or are not candidates for nerve-sparing surgery. Agents such as phosphodiesterase inhibitors, immunophilin ligands, and recombinant human erythropoietin have demonstrated potential benefits in early reports of both in-vitro and ongoing clinical trials. SUMMARY: Currently, no standard treatment or prophylaxis exists for posttreatment erectile dysfunction. Neuro-protective and regenerative therapies, including the immunophilin ligands, hold promise to reduce the morbidity of localized prostate cancer therapy.
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