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Surgical Techniques for Managing Post-prostatectomy Erectile Dysfunction

Castiglione, F; Ralph, DJ; Muneer, A; (2017) Surgical Techniques for Managing Post-prostatectomy Erectile Dysfunction. Current Urology Reports , 18 (11) , Article 90. 10.1007/s11934-017-0735-2. Green open access

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Abstract

PURPOSE OF REVIEW: Due to the increasing numbers of radical prostatectomies (RP) performed for prostate cancer, a substantial number of patients are now suffering from post-operative erectile dysfunction (ED). The aim of this study is to summarize the current literature on surgical techniques for managing post-prostatectomy erectile dysfunction. RECENT FINDINGS: The PubMed database was searched for English-language articles published up to Jan 2017 using the following search terms: “prostatectomy AND erectile dysfunction”, “prostatectomy AND penile prostheses”, and “prostatectomy AND penile implants”. All of the studies that evaluated medical treatment were excluded. In the last few decades, the understanding of the anatomy of the male pelvis and prostate has improved. This has led to significant changes in the nerve-sparing radical prostatectomy techniques, with the aim of preserving post-surgical erectile function (EF). In this scenario, the prostate vascular supply and the anatomy of the neurovascular bundles have a central role. Penile prosthesis implantation is considered the third-line treatment option for RP ED patients, and they have been reported to be a very successful treatment with the highest patient satisfaction rate. SUMMARY: Considering the failure of penile rehabilitation, and the lack of evidence for accessory pudendal artery (APA) preservation and nerve graft, nerve-sparing surgery and penile prostheses represent, today, the only methods to permanently and definitively preserve or erectile function after RP.

Type: Article
Title: Surgical Techniques for Managing Post-prostatectomy Erectile Dysfunction
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s11934-017-0735-2
Publisher version: http://doi.org/10.1007/s11934-017-0735-2
Language: English
Additional information: © The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Keywords: Science & Technology, Life Sciences & Biomedicine, Urology & Nephrology, Erectile function after radical prostatectomy, Nerve-sparing radical prostatectomy, Radical prostatectomy outcome, ASSISTED RADICAL PROSTATECTOMY, CAVERNOUS NERVE INJURY, INFLATABLE PENILE PROSTHESIS, ACCESSORY PUDENDAL ARTERIES, STEM-CELL THERAPY, RETROPUBIC PROSTATECTOMY, URINARY-INCONTINENCE, SEXUAL DYSFUNCTIONS, RAT MODEL, GRAFT RECONSTRUCTION
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Surgical Biotechnology
URI: https://discovery.ucl.ac.uk/id/eprint/10024312
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