ERECTILE DYSFUNCTION AND TREATMENT AFTER RETROPUBIC RADICAL PROSTATECTOMY

Abstract

Introduction: The incidence of erectile dysfunction in men following radical prostatectomy has been estimated to range between 16% and 82%. The most important predictors of erectile function are pre-operative erectile function and nerve sparing nature of the procedure. The former is determined by age and vascular risk-factors whereas the latter is decided by the stage of the tumor and the skill of the surgeon. Apoptosis of corporeal smooth muscle cells plays a significant role in the development of cavernosal dysfunction following radical prostatectomy. Symptomatic therapy may be applied according to the current general standards of treatment in men with erectile dysfunction (ED). In addition, pharmacological prophylaxis and treatment of postoperative ED with different treatment alternatives is effective and safe, and PDE5 inhibitors have similar outcome after radical prostatectomy. The concepts of cavernous nerve reconstruction and neuroprotection have been associated to promising results.