Erectile function after radical prostatectomy: a review.
OBJECTIVE
Although the high rate of erectile dysfunction (ED) following prostatectomy is well recognised, the aetiology and pathophysiology have not yet been fully elucidated. We examined the current literature as to aetiology, treatment and possible prevention of ED following prostatectomy.


METHODS
Review of the literature by a Medline search.


CONCLUSIONS
The most important predictors of erectile function are pre-operative erectile function and the 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 tumour and the skill of the surgeon. The value of intraoperative nerve mapping seems limited and the importance of nerve grafting is uncertain. Natural recovery of erection can take as long as 24 months. Patients complain about a lack of professional support. Symptomatic therapy may be applied according to the current general standards of treatment in men with ED.
Meuleman
E J H
EJ
Department of Urology, University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. e.mouleman@uro.umcn.nl
Mulders
P F A
PF
D000527:Alprostadil / Q000627:therapeutic use; D007172:Erectile Dysfunction / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control / Q000523:psychology; D006801:Humans; D008297:Male; D010410:Penile Erection / Q000502:physiology*; D015917:Penile Prosthesis; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D010879:Piperazines / Q000627:therapeutic use; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control / Q000523:psychology; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000601:surgery*; D011687:Purines; D011788:Quality of Life; D012307:Risk Factors; D000068677:Sildenafil Citrate; D013450:Sulfones; D014618:Vacuum; D014665:Vasodilator Agents / Q000627:therapeutic use
D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate; D000527:Alprostadil