Penile rehabilitation following radical prostatectomy.
OBJECTIVE
Erectile dysfunction is common after radical prostatectomy. Erectile dysfunction has a negative impact on health-related quality of life. Penile rehabilitation is defined as the use of any drug or device at or after radical prostatectomy to maximize erectile function recovery. This is an up-to-date review of the current state of science supporting penile rehabilitation after radical prostatectomy.


RESULTS
The purpose of penile rehabilitation is to prevent corpus cavernosal smooth muscle structural alterations to not only maximize the chances of a man to recover functional erections but also return him to his preoperative erectile function level. Current animal and human data support the use of PDE5 inhibitor and the generation of early erections after radical prostatectomy as a strategy to improve erectile function recovery. The magnitude of this improvement is currently unclear.


CONCLUSIONS
The results from animal and human studies imply that the use of PDE5 inhibitor and the generation of erections early after radical prostatectomy are of some benefit to erectile function recovery. Although the definitive protocol for rehabilitation is not defined, future work is aimed at determining this.
Mulhall
John P
JP
Urology Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. jpm2005@med.cornell.edu
D000818:Animals; D054706:Cyclic Nucleotide Phosphodiesterases, Type 5 / Q000378:metabolism; D007172:Erectile Dysfunction / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D010101:Oxygen Consumption; D010410:Penile Erection / Q000187:drug effects*; D010413:Penis / Q000098:blood supply / Q000187:drug effects* / Q000201:enzymology / Q000503:physiopathology; D058986:Phosphodiesterase 5 Inhibitors; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D011468:Prostatectomy / Q000009:adverse effects*; D020127:Recovery of Function; D016896:Treatment Outcome
D058986:Phosphodiesterase 5 Inhibitors; D010726:Phosphodiesterase Inhibitors; D054706:Cyclic Nucleotide Phosphodiesterases, Type 5