Current concepts in the management of post-radical prostatectomy impotence.
Erectile dysfunction after radical retropubic prostatectomy has a multifactorial aetiology, including both neurogenic and vasculogenic factors. Postoperative potency is improved with preservation of the neurovascular bundles in a nerve-sparing procedure. Preoperative and intraoperative identification and preservation of accessory pudendal arteries may also improve postoperative potency rates. The early institution of treatment with intracavernous alprostadil appears to improve postoperative potency rates. Treatment with newer therapeutic agents, such as Sildenafil and Invicorp, are both efficacious and well tolerated.
McMahon
C G
CG
Australian Centre for Sexual Health, St Luke's Hospital, Hemsley House, 20 Roslyn Street Potts Point, New South Wales 2011, Australia. cmcmahon@extro.ucc.su.oz.au