Sexual func-tion of patients undergoing radical prostatectomy: a modern view of the problem


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Radical prostatectomy (RP) is deemed to be the most effective standard treatment option for men with prostate cancer (PC). However, RP is accompanied by a number of complications leading to a substantial decline in the quality of sexual life of operated patients. Major complications of RP include: decreased sex drive, deterioration of erectile function, deformation of the penis, abnormal ejaculation and orgasmic dysfunction. Based on the current literature, the article deals with the issue of prevention and rehabilitation of patients after radical prostatectomy, describes the methods of conservative and surgical correction of complications, associated with surgical treatment of PC.

Full Text

Restricted Access

About the authors

P. V Glybochko

Research Institute of Uronephrology and Human Reproductive Health of Sechenov First Moscow State Medical University

I. P Matjuhov

Research Institute of Uronephrology and Human Reproductive Health of Sechenov First Moscow State Medical University

Email: matyukhovip@gmaiI.com
Ph.D., Senior Research Fellow of Department of Andrology

Ju. G Aljaev

Research Institute of Uronephrology and Human Reproductive Health of Sechenov First Moscow State Medical University

N. D Ahvlediani

Research Institute of Uronephrology and Human Reproductive Health of Sechenov First Moscow State Medical University

Zh. Sh Inojatov

Research Institute of Uronephrology and Human Reproductive Health of Sechenov First Moscow State Medical University

References

  1. Boyle P., Ferlay J. Cancer incidence and mortality in Europe 2004. Ann. Oncol. 2005;16(3):481-488.
  2. Bill-Axelson A., Holmberg L., FiMn F., Ruutu M., Garmo H., Busch C., Nordling S., Hdggman M., Andersson S.O., Bratell S., Spеngberg A., Palmgren J., Adami H.O., Johansson J.E.; Scandinavian Prostate Cancer Group Study Number 4. Scandinavian Prostate Cancer Group Study Number 4. Radical prostatectomy versus watchful waiting in localized prostate cancer: the Scandinavian prostate cancer group-4 randomized trial. J. Natl. Cancer. Inst. 2008;100(16):1144-1154.
  3. Maffezzini M., Seveso M., Taverna G., Giusti G., Benetti A., Graziotti P. Evaluation of complications and results in a contemporary series of 300 consecutive radical retropubic prostatectomies with the anatomic approach at a single institution. Urology. 2003; 61(5):982-986.
  4. Salonia A., Burnett A.L., Graefen M., Hatzimouratidis K., Montorsi F., Mulhall J.P., Stief C. Preservation and management of postprostatectomy sexual dysfunctions Part 2: Recovery and preservation of erectile function, sexual desire, and orgasmic function. Eur. Urol. 2012;62:273-286.
  5. EAU Guidelines on Prostate Cancer. 2014.
  6. Turns D. Psychosocial issues: pelvic exenterative surgery. J. Surg. Oncol. 2001;76(3):224-236.
  7. Visser M.R., van Lanschot J.J., van der Velden J., Коек J.J., Gouma D.J., Spangers M.A. Quality of life in newly diagnosed cancer patients waiting for surgery is seriously impaired. J. Surg. Oncol. 2006; 93:571-577.
  8. Gacci M., Corona G., Apolone G., Lanciotti M., Tosi N., Giancane S., Masieri L., Serni S., Maggi M., Carini M. Influence of serum testosterone on urinary incontinence and sexual activity in patients undergoing radical prostatectomy for clinical localized prostate cancer. Prostate Cancer Prostatic Dis. 2010;13:168-172.
  9. Montorsi F., Guazzoni G., Strambi L.F., Da Pozzo L.F., Barbieri L., Rigatti P., Pizzini G., Miani A. 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;158:1408-1410.
  10. Crawford D., Morales A., Salonia A., Morgentaler A. Collaborative Review - Andrology. A New Era of Testosterone and Prostate Cancer: From Physiology to Clinical Implications. Eur. Urol. 2014;65:115-123.
  11. Leibowitz R.L., Dorff T.B., Tucker S., Symanowski J., Vogelzang N.J. Testosterone replacement therapy in prostate cancer survivors with hypogonadal symptoms. BJU Int. 2010;105:1397-1401.
  12. Khera M., Grober E.D., Najari B., Colen J.S., Mohamed O., Lamb D.J., Lipshultz L.I. Testosterone replacement therapy following radical prostatectomy. J. Sex Med. 2009;6:1165-1170.
  13. Shabsigh R., Crawford E.D., Nehra A., Slawin K.M. Testosterone therapy in hypogonadal men and potential prostate cancer risk: a systematic review. Int. J. Impot. Res. 2009;21:9-23.
  14. Feneley M.R., Carruthers M. Is testosterone treatment good for the prostate? Study of safety during long-term treatment. J. Sex Med. 2012;9:2138-2149.
  15. Calof O.M., Singh A.B., Lee M.L., Kenny A.M., Urban R.J., Tenover J.L., Bhasin S. Adverse events associated with testosterone replacement in middle-aged and older men: a metaanalysis of randomized, placebo- controlled trials. J. Gerontol. A Biol. Sci Med. Sci. 2005;60:1451-1457.
  16. Walsh P.C., Donker P.J. Impotence following radical prostatectomy: insight into etiology and prevention. J. Urol. 1982;128(3):492-497.
  17. Walsh P.C. Anatomic radical prostatectomy: evolution of the surgical technique. J. Urol. 1998;160:2418-2424.
  18. Tewari A., Takenaka A., Mtui E., Horninger W., Peschel R., Bartsch G., Vaughan E.D. The proximal neurovascular plate and the tri-zonal neural architecture around the prostate gland: importance in the athermal robotic technique of nervesparing prostatectomy. BJU Int. 2006;98:314-323.
  19. Costello A.J., Brooks M., Cole O.J. Anatomical studies of the neurovascular bundle and cavernosal nerves. BJU Int. 2004;94:1071-1076.
  20. Montorsi F., Salonia A., Suardi N., Gallina A., Zanni G., Briganti A., Deho’ F., Naspro R., Farina E., Rigatti P. Improving the preservation of the urethral sphincter and neurovascular bundles during open radical retropubic prostatectomy. Eur. Urol. 2005;48(6):938-945.
  21. Eichelberg C., Erbersdobler A., Michl U., Schlomm T., Salomon G., Graefen M., Huland H. Nerve distribution along the prostatic capsule. Eur. Urol. 2007;51:105-111.
  22. Байкова Н.В., Павленко К.А., Кызласов П.С. Сравнение результатов открытого и лапароскопического методов лечения рака предстательной железы. Материалы XIV Конгресса Российского общества урологов. C. 133.
  23. Ball A.J., Gambill B., Fabrizio M.D., Davis J.W., Given R.W., Lynch D.F., Shaves M., Schellhammer P.F. Prospective longitudinal comparative study of early health-related quality- oflife outcomes in patients undergoing surgical treatment for localized prostate cancer: a shortterm evaluation of five approaches from a single institution. J. Endourol. 2006;20:723.
  24. Ficarra V., Novara G., Artibani W., Cestari A., Galfano A., Graefen M., Guazzoni G., Guillonneau B., Menon M., Montorsi F., Patel V., Rassweiler J., Van Poppel H. Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a systematic review and cumulative analysis of comparative studies. Eur. Urol. 2009;55:1037-1063.
  25. Alemozaffar M., Regan M.M., Cooperberg M.R., Wei J.T., Michalski J.M., Sandler H.M., Hembroff L., Sadetsky N., Saigal C.S., Litwin M.S., Klein E., Kibel A.S., Hamstra D.A., Pisters L.L., Kuban D.A., Kaplan I.D., Wood D.P., Ciezki J., Dunn R.L., Carroll P.R., Sanda M.G. Prediction of erectile function following treat-ment for prostate cancer. JAMA. 2011;306:1205-1214.
  26. Mulhall J.P., Bella A.J., Briganti A., McCullough A., Brock G. Erectile dysfunction rehabilitation in the radical prostatectomy patient. J. Sex Med. 2010;7(4 Pt 2):1687-1698.
  27. Mulhall J.P., Mongentalar A. Penile rehabilitation should become the norm for radical prostatectomy patients. J. Sex Med. 2007;4:538-543.
  28. Rogers C.G., Trock B.P., Walsh P.C. Preservation of accessory pudendal arteries during radical retropubic prostatectomy: surgical technique and results. Urology. 2004;64:148-151.
  29. Box G.N., Kaplan A.G., Rodriguez Jr.E., Skarecky D.W., Osann K.E., Finley D.S., Ahlering T.E. Sacrifice of accessory pudendal arteries in normally potent men during robot-assisted radical prostatectomy does not impact potency. J. Sex Med. 2010;7:298-303.
  30. Potosky A.L., Davis W.W., Hoffman R.M., Stanford J.L., Stephenson R.A., Penson D.F., Harlan L.C. Five-year outcomes after prostatectomy or radiotherapy for prostate cancer: The prostate cancer outcomes study. J. Natl. Cancer Inst. 2004;69:1358-1367.
  31. Snyder K.M., Stock R.G., Buckstein M., Stone N.N. Long-term potency preservation following bracytherapy for prostate cancer. BJU Int. 2012;110:221-225.
  32. Hatzimouratidis K., Burnett A.L., Hatzichristou D., McCullogh A.R., Montorsi F., Mulhall J.P. Phosphodiesterase type 5 inhibitors in postprostatectomy erectile dysfunction: A critical analysis of the basic science rationale and clinical application. Eur. Urol. 2009;5:334-347.
  33. Gallina A., Ferrari M., Suardi N., Capitanio U., Abdollah F., Tutolo M., Bianchi M., Sacca A., Salonia A., Rigatti P., Montorsi F., Briganti A. Erectile function outcome after bilateral nerve- sparing radical prostatectomy: Which patients may be left untreated? J. Sex Med. 2012;9:903-908.
  34. Briganti A., Gallina A., Suardi N., Capitanio U., Tutolo M., Bianchi M., Passoni N., Salonia A., Colombo R., Di Girolamo V., Guazzoni G., Rigatti P., Montorsi P. Predicting erectile function recovery after bilateral nerve sparing radical prostatectomy: A proposal of a novel preoperative risk stratification. J. Sex Med. 2010;7:2521-2531.
  35. Montorsi F., Brock G., Lee J., Shapiro J., Van Poppel H., Graefen M., Stief C. Effect of nightly versus on-demand vardenafil on recovery of erectile function in men following bilateral nerve-sparing radical prostatectomy. Eur. Urol. 2008;54:924-931.
  36. Domes T., Chung E., DeYoung L., MacLean N., Al-Shaiji T., Brock G. Clinical outcomes of intracavernosal injection in postprostatectomy patients: a single-center experience. Urology. 2012;79:150-155.
  37. Purvis K., Egdetveit I., Christiansen E. Intracavernosal therapy for erectile failure - impact of treatment and reasons for drop-out and dissatisfaction. Int. J. Impot. Res. 1999;11:287-299.
  38. Raina R., Agarwal A., Ausmundson S., Lakin M., Nandipati K.C., Montague D.K., Mansour D., Zippe C.D. Early use of vacuum constriction device following radical prostatectomy facilitates early sexual activity and potentially earlier return of erectile function. Int. J. Impot. Res. 2006;18:77-81.
  39. Kqhler T.S., Pedro R., Hendlin K., Utz W., Ugarte R., Reddy P., Makhlouf A., Ryndin I., Canales B.K., Weiland D., Nakib N., Ramani A., Anderson J.K., Monga M. A pilot study on the early use of the vacuum erection device after radical retropubic prostatectomy. BJU Int. 2007; 100:858-862.
  40. Sexual Rehabilitation and Cancer Survivorship: A State of Art Review of Current Literature and Management Strategies in Male Sexual Dysfunction Among Prostate Cancer Survivors. J. Sex Med. 2013;10(1):102-111.
  41. Ramwash H.J., Morgentaler A., Covino N., Barlow D.H., DeWolf W.C. Quality of life following simultaneous placement of penile prosthesis with radical prostatectomy. J. Urol. 2005;174:1395-1398.
  42. Wilson S.K., Delk J.R., Salem E.A., Cleves M.A. Long-term survival of inflatable penile prostheses: single surgical group experience with 2384 first-time implants spanning two decades. J. Sex Med. 2007;4:1074-1079.
  43. Heron M., Hoyert D.L., Murphy S.L., Xu J., Kochanek K.D., Tejada-Vera B. Deaths: Final data for 2006. Natl. Vital. Stat. Rep. 2009;57:1-134.
  44. Menard J., Tremeaux J.C., Faix A., Pierrevelcin J., Staerman F. Erectile function and sexual satisfaction before and after penile prosthesis implantation in radical prostatectomy patients: a comparison with patients with vasculogenic erectile dysfunction. J. Sex Med. 2011;8:3479-3486.
  45. Tal R., Jacks L.M., Elkin E., Mulhall J.P. Penile implant utilization following treatment for prostate cancer: Analysis of the SEER-Medicare database. J. Sex Med. 2011;8:1797-1804.
  46. Burnett A.L., Allaf M.E., Bivalacqua T.J. Erythropoietin promotes erection recovery after nerve-sparing radical retropubic prostatectomy: A retrospective analysis. J. Sex Med. 2008;5:2392-2398.
  47. McCullogh A. Penile change following radical prostatectomy: Size, smooth muscle atrophy and curve. Curr. Urol. Rep. 2008;9:492-499.
  48. Gontero P., Galzerano M., Bartoletti R., Magnani C., Tizzani A., Frea B., Mondaini N. New insights into the pathogenesis of penile shortening after radical prostatectomy and the role of postoperative sexual function. J. Urol. 2007;178:602-607.
  49. Tal R., Heck M., Teloken P., Siegrist T., Nelson C.J., Mulhall J.P. Peyronie’s disease following radical prostatectomy: Incidence and predictors. J. Sex Med. 2010;7:1254-1261.
  50. Briganti A., Fabbri F., Salonia A., Gallina A., Chun F.K., Deho F., Zanni G., SuardiN., Karakiewicz P.I., Rigatti P., Montorsi F. Preserved postoperative penile size correlates well with maintained erectile function after bilateral nerve-sparing radical retropubic prostatectomy. Eur. Urol. 2007; 52:702-707.
  51. User H.M., Hairston J.H., Zelner D.J., McKenna K.E., McVary K.T. Penile weight and cell subtype specific changes in a post- radical prostatectomy model of erectile dysfunction. J. Urol. 2003;169:1175-1179.
  52. Dalkin B.L., Christopher B.A Preservation of penile length after radical prostatectomy: Early intervention with a vacuum erection device. Int. J. Impot. Res. 2007;19:501-504.
  53. Barnas J., Pierpaoli S.,L add P., Valenzuela R., Aviv N., Parker M., Waters W.B., Flanigan R.C., Mulhall J.P. The prevalence and nature of orgasmic dysfunction after radical prostatectomy. BJU Int. 2004;94:603-605.
  54. Schover L.R., Fouladi R.T., Warneke C.L., Neese L., Klein E.A., Zippe C. , Kupelian P.A. Defining sexual outcomes after treatment for localised prostate carcinoma. Cancer. 2002;95:1773-1785.
  55. Huyghe E., Delannes M., Wagner F., Delaunay B., Nohra J., Toulouzan M., Shutyee J.Y., Plante P., Soulie M., Thnneau P., Bachaud J.M. Ejaculatory function after permanent 125I prostate brachytherapy for localized prostate cancer. Int. J. Radiat. Oncol. Biol. Phys. 2009;74:126-132.
  56. Barnas J.L., Pierpaoli S., Ladd P., Valenzuela R., Aviv N., Parker M., Waters W.B., Flanigan R.C., Mulhall J.P. The prevalence and nature of orgasmic dysfunction after radical prostatectomy. BJU Int. 2004;94: 603-605.
  57. Martэnez-Salamanca J., Martэnez-Ballesteros C., Portillo I., Moncada L., Carballido J. Penile morphometric changes after radical prostatectomy: evidence-based [in Spanish]. Actas. Urol. Esp. 2010;34:579-585.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies