Penile rehabilitation should become the norm for radical prostatectomy patients.
BACKGROUND
The Journal of Sexual Medicine (JSM) held a debate at the annual fall meeting of the Sexual Medicine Society of North America (SMSNA). The motion was "Penile Rehabilitation Should Become the Norm for Radical Prostatectomy Patients." At the suggestion of several SMSNA members, it was requested that this debate might be of interest to JSM readers in the form of a published controversy.


METHODS
Two debate speakers with expertise and/or strong opinions in the area of penile rehabilitation submitted their literature-review, evidence-based opinions on the topic.


METHODS
Literature review of laboratory basic science and clinical research studies on penile rehabilitation.


RESULTS
Penile rehabilitation involves prophylactic procedures designed to improve oxygen delivery to penile erectile tissues, aimed at preserving erectile tissue health and minimizing erectile tissue damage that otherwise occurs during the period of neural recovery to the autonomic cavernosal nerve following radical prostatectomy. There are several studies in the sexual medicine literature on penile rehabilitation after radical prostatectomy, and the positive results appear to support this concept, the rationale, and mechanism. The use of prophylactic penile rehabilitation programs has not been fully elucidated, nor have the results been replicated in large multicenter placebo-controlled trials.


CONCLUSIONS
Penile rehabilitation may be performed along with counseling with the couple, vacuum erection therapy, and vacuum erection device therapy if it is the patient and partner's preference, provided that it is undertaken in a safe and effective manner and is monitored closely.
Mulhall
John P
JP
Sexual Medicine Program, Department of Urology, Memorial Sloan Kettering Cancer Center, New York, NY, USA;. Electronic address: jpm2005@med.cornell.edu.
Morgentaler
Abraham
A
Men's Health Boston, Department of Urology, Harvard Medical School, Boston, MA, USA.
D003131:Combined Modality Therapy; D003226:Congresses as Topic; D007172:Erectile Dysfunction / Q000209:etiology / Q000517:prevention & control / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D010413:Penis / Q000294:innervation / Q000503:physiopathology*; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D011467:Prostate / Q000294:innervation; D011468:Prostatectomy / Q000009:adverse effects / Q000534:rehabilitation*; D011471:Prostatic Neoplasms / Q000601:surgery; D011788:Quality of Life; D012649:Self Concept; D014481:United States
D010726:Phosphodiesterase Inhibitors