Current therapeutic strategies for erectile function recovery after radical prostatectomy – literature review and meta-analysis
Abstract
Radical prostatectomy is the most commonly performed treatment option for localised prostate cancer. In the last decades the surgical technique has been improved and modified in order to satisfy both oncological safety and postoperative functional results. Urinary incontinence and erectile dysfunction (ED) are the main postoperative functional impairments in patients that undergo radical prostatectomy (RP). [1] According to the EAU Guidelines erectile dysfunction is defined as “the persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance”. To this moment it is estimated that 25-75% of the patients who underwent RP develop ED with major implications in postoperative quality of life. [2] Various risk factors can be related to post-prostatectomy ED, among which the most important are the patient’s age, comorbidities, preoperative erectile function, but also surgical approach (robot-assisted, laparoscopic, open) and nerve-sparing technique (inter/intrafascial). [2, 3] Among physiopathological modifications that concur to ED, the nerve damage (neuropraxia) appears to be the main domino piece that triggers other alterations like structural changes of the smooth muscle, arterial damage and veno-oclusive dysfunction which lead to cavernosal oxygenation impairments. [4–6] The clinical results of physiopathological alterations are shortening of penile size, impairment of orgasm and ejaculation achievement which have tremendous impact…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 11,831 participants or records.
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