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Current management of penile rehabilitation


Authors: T. S. Hakky;  A. S. Baumgarten;  Y. Zheng;  J. Emtage;  J. Parker;  D. Martinez;  R. E. Carrion
Published in: Urol List 2013; 11(4): 6-10

Overview

Erectile dysfunction is commonly experienced after radical prostatectomy and has been attributed to injury to vascular, neurogenic, and smooth muscle injury. The concept of rehabilitation after organ injury is not a novel concept and is one that has been applied to all aspects of medicine. Penile rehabilitation has been defined as the use of a device or medication to improve erectile function after radical prostatectomy. Here we redefine penile rehabilitation as the use of any device, medication, or intervention to promote male sexual function as a primer before and after any insult to the penile erectile physiologic axis. We also review the epidemiology, rational and current literature on penile rehabilitation after prostatectomy.

Key words:
erectile dysfunction, penile rehabilitation, radical prostatectomy, intracavernosal injections, inflatable penile prosthesis, phosphodiesterase inhibitors


Sources

1. Lue TFH. Pathophysiology of Erectile Dysfunction. Campbell-Walsh Urology. Elsevier Inc.; 2000: ­668–670.

2. Setter SM, Iltz JL, Fincham JE, Campbell RK, Baker DE. Phosphodiesterase 5 inhibitors for erectile dysfunction. Ann Pharmacother 2005; 39(7–8): 1286–95.

3. Budaus L, Huland H, Graefen M. Controversies in the management of localized prostate cancer: radical prostatectomy still the standard of care. Crit rev oncol hematol 2012; 84 (Suppl 1): e24-9.

4. Stanford JL, Feng Z, Hamilton AS, Gilliland FD, Stephenson RA, Eley JW et al. Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: the Prostate Cancer Outcomes Study. JAMA 2000; 283(3): 354–60.

5. Penson DF, McLerran D, Feng Z, Li L, Albertsen PC, Gilliland FD et al. 5-year urinary and sexual outcomes after radical prostatectomy: results from the Prostate Cancer Outcomes Study. J Urol 2008; 179 (5 Suppl): S40–4.

6. Hu JC, Elkin EP, Pasta DJ, Lubeck DP, Kattan MW, Carroll PR et al. Predicting quality of life after radical prostatectomy: results from CaPSURE. J Urol 2004; 171(2 Pt 1): 703–7; discussion 7–8.

7. Eilat-Tsanani S, Tabenkin H, Shental J, Elmalah I, Steinmetz D. Patients‘ perceptions of radical prostatectomy for localized prostate cancer: a qualitative study. Isr Med Assoc J 2013; 15(3): 153–7.

8. Kendirci M, Bejma J, Hellstrom WJ. Update on erectile dysfunction in prostate cancer patients. Curr Opin Urol 2006; 16(3): 186–95.

9. Kury P, Stoll G, Muller HW. Molecular mechanisms of cellular interactions in peripheral nerve regeneration. Curr Opin Neurol 2001; 14(5): 635–9.

10. Leungwattanakij S, Bivalacqua TJ, Usta MF, Yang DY, Hyun JS, Champion HC et al. Cavernous neurotomy causes hypoxia and fibrosis in rat corpus cavernosum. J Androl 2003; 24(2): 239–45.

11. Segal R, Burnett AL. Erectile preservation following radical prostatectomy. Ther Adv Urol 2011; 3(1): 35–46.

12. Kuthe A. Phosphodiesterase 5 inhibitors in male sexual dysfunction. Curr Opin Urol 2003; 13(5): 405–10.

13. Alwaal A, Al-Mannie R, Carrier S. Future prospects in the treatment of erectile dysfunction: focus on avanafil. Drug Des Devel Ther 2011; 5: 435–43.

14. Carrier S, Zvara P, Nunes L, Kour NW, Rehman J, Lue TF. Regeneration of nitric oxide synthase-containing nerves after cavernous nerve neurotomy in the rat. J Urol 1995; 153(5): 1722–7.

15. Yamashita S, Kato R, Kobayashi K, Hisasue S, Arai Y, Tsukamoto T. Nerve injury-related erectile dysfunction following nerve-sparing radical prostatectomy: a novel experimental dissection model. Int J Urol 2009; 16(11): 905–11.

16. Sirad F, Hlaing S, Kovanecz I, Artaza JN, Garcia LA, Rajfer J et al. Sildenafil promotes smooth muscle preservation and ameliorates fibrosis through modulation of extracellular matrix and tis­sue growth factor gene expression after bilateral cavernosal nerve resection in the rat. J Sex Med 2011; 8(4): 1048–60.

17. Facio F, Jr., Burnett AL. Penile rehabilitation and neuromodulation. ScientificWorldJournal 2009; 9: 652–64.

18. Yuan J, Hoang AN, Romero CA, Lin H, Dai Y, Wang R. Vacuum therapy in erectile dysfunction – science and clinical evidence. Int J Impot Res 2010; 22(4): 211–9.

19. Klein LT, Miller MI, Buttyan R, Raffo AJ, Burchard M, Devris G et al. Apoptosis in the rat penis after penile denervation. J Urol 1997; 158(2): 626–30.

20. User HM, Hairston JH, Zelner DJ, McKenna KE, McVary KT. Penile weight and cell subtype specific changes in a post-radical prostatectomy model of erectile dysfunction. J Urol 2003; 169(3): 1175–9.

21. Ferrini MG, Davila HH, Kovanecz I, Sanchez SP, Gonzalez-Cadavid NF, Rajfer J. Vardenafil prevents fibrosis and loss of corporal smooth muscle that occurs after bilateral cavernosal nerve resection in the rat. Urology 2006; 68(2): 429–35.

22. Padma-Nathan H, McCullough AR, Levine LA, Lipshultz LI, Siegel R, Montorsi F et al. Randomized, double-blind, placebo-controlled study of postoperative nightly sildenafil citrate for the prevention of erectile dysfunction after bilateral nerve-sparing radical prostatectomy. Int J Impot Resh 2008; 20(5): 479–86.

23. Bannowsky A, Schulze H, van der Horst C, Hautmann S, Junemann KP. Recovery of erectile function after nerve-sparing radical prostatectomy: improvement with nightly low-dose sildenafil. BJU Int 2008; 101(10): 1279–83.

24. Zippe CD, Pahlajani G. Vacuum erection devices to treat erectile dysfunction and early penile rehabilitation following radical prostatectomy. Cur Urol Rep 2008; 9(6): 506–13.

25. Basal S, Wambi C, Acikel C, Gupta M, Badani K. Optimal strategy for penile rehabilitation after robot-assisted radical prostatectomy based on preoperative erectile function. BJU Int 2013; 111(4): 658–65.

26. Montorsi F, Guazzoni G, Strambi LF, Da Pozzo LF, Nava L, Barbieri L et al. Recovery of spontaneous erectile function after nerve-sparing radical retropubic prostatectomy with and without early intracavernous injections of alprostadil: results of a prospective, randomized trial. J Urol 1997; 158(4): 1408–10.

27. Raina R, Pahlajani G, Agarwal A, Jones S, Zippe C. Long-term potency after early use of a vacuum erection device following radical prostatectomy. BJU Int 2010; 106(11): 1719–22.

28. Kohler TS, Pedro R, Hendlin K, Utz W, Ugarte R, Reddy P et al. A pilot study on the early use of the vacuum erection device after radical retropubic prostatectomy. BJU Int 2007; 100(4): 858–62.

29. Sellers TDM, Salem EA, Wilson SK. Vacuum Preparation, Optimization of Cylinder Length and Postoperative Daily Inflation Reduces Complaints of Shortened Penile Length Following Implantation of Inflatable Penile Prosthesis. Adv Sex Med 2013(3): 14–8.

30. McCullough AR, Hellstrom WG, Wang R, Lepor H, Wagner KR, Engel JD. Recovery of erectile function after nerve sparing radical prostatectomy and penile rehabilitation with nightly intraurethral alprostadil versus sildenafil citrate. J Urol 2010; 183(6): 2451–6.

31. Montague DK, Jarow JP, Broderick GA, Dmochowski RR, Heaton JP, Lue TF et al. Chapter 1: The management of erectile dysfunction: an AUA update. J Urol 2005; 174(1): 230–9.

32. Gontero P, Fontana F, Bagnasacco A, Panella M, Kocjancic E, Pretti G et al. Is there an optimal time for intracavernous prostaglandin E1 rehabilitation following nonnerve sparing radical prostatectomy? Results from a hemodynamic prospective study. J Urol 2003; 169(6): 2166–9.

33. Mydlo JH, Volpe MA, MacChia RJ. Results from different patient populations using combined therapy with alprostadil and sildenafil: predictors of satisfaction. BJU Int 2000; 86(4): 469–73.

34. Nehra A, Blute ML, Barrett DM, Moreland RB. Rationale for combination therapy of intraurethral prostaglandin E(1) and sildenafil in the salvage of erectile dysfunction patients desiring noninvasive therapy. Int J Impot Res 2002;14 Suppl 1: S38–42.

35. Mulhall J, Land S, Parker M, Waters WB, Flanigan RC. The use of an erectogenic pharmacotherapy regimen following radical prostatectomy improves recovery of spontaneous erectile function. J Sex Med 2005;2(4): 532–40; discussion 40–2.

36. Muller A, Tal R, Donohue JF, Akin-Olugbade Y, Kobylarz K, Paduch D et al. The effect of hyperbaric oxygen therapy on erectile function recovery in a rat cavernous nerve injury model. J Sex Med 2008; 5(3): 562–70.

37. Albersen M, Joniau S, Claes H, Van Poppel H. Preclinical evidence for the benefits of penile rehabilitation therapy following nerve-sparing radical prostatectomy. Adv Urol 2008: 594868.

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