The concept of erectile function preservation (penile rehabilitation) in the patient after brachytherapy for prostate cancer Journal Article
| Authors: | Stember, D. S.; Mulhall, J. P. |
| Article Title: | The concept of erectile function preservation (penile rehabilitation) in the patient after brachytherapy for prostate cancer |
| Abstract: | Purpose: Radiation therapy (RT) for prostate cancer is commonly associated with erectile dysfunction (ED), although high-quality data on incidence of ED after brachytherapy (BT) are limited. We reviewed the literature on BT-related ED and propose a clinical pathway for maximal preservation of erectile function (EF) after treatment. Methods and Materials: Erectile physiology and pathophysiology after RT are reviewed. Evidence and rationale for the concept of penile rehabilitation are presented. BT literature that focuses on ED is identified. A clinical care pathway for maximally preserving EF in patients treated with RT for localized prostate cancer is proposed. Results: The mechanisms contributing to ED after prostate irradiation involve injury to the neurovascular bundles, penile vasculature, and cavernosal structural tissue. Reported rates of ED after BT vary widely. Basic science and clinical studies support the concept of a structured program of erectile tissue preservation for optimizing EF after radical prostatectomy and are adapted for the prostate radiation patient. Conclusions: Although definitive evidence for such erectile tissue preservation strategies is pending, there is a solid scientific rationale for the application of available strategies to the radiation patient. © 2012 American Brachytherapy Society. |
| Keywords: | cancer survival; cancer surgery; review; cancer localization; placebo; drug efficacy; nonhuman; treatment duration; pathophysiology; cancer radiotherapy; postoperative care; radiation dose; follow up; prostate specific antigen; low drug dose; apoptosis; radiation; in vitro study; drug effect; prostate cancer; sexuality; prostatectomy; brachytherapy; organ preservation; drug blood level; rehabilitation; erectile dysfunction; androgen deprivation therapy; nervous system development; phosphodiesterase v inhibitor; prostaglandin e1; sildenafil; tadalafil; vardenafil; libido; sexual behavior; enzyme synthesis; penis erection; erectile function; tissue preservation; mean arterial pressure; cyclic gmp; pde5 inhibitor; sexual health; penile blood flow; male genital system function; reproductive procedures |
| Journal Title: | Brachytherapy |
| Volume: | 11 |
| Issue: | 2 |
| ISSN: | 1538-4721 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2012-03-01 |
| Start Page: | 87 |
| End Page: | 96 |
| Language: | English |
| DOI: | 10.1016/j.brachy.2012.01.002 |
| PROVIDER: | scopus |
| PUBMED: | 22330103 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 2 April 2012" - "CODEN: BRACC" - "Source: Scopus" |
