Current state of penile rehabilitation after radical prostatectomy.
OBJECTIVE
Erectile dysfunction is a major source of morbidity for many men who undergo radical prostatectomy for localized prostate cancer annually. Few areas of urology remain as controversial as penile rehabilitation postprostatectomy, an ill defined treatment strategy designed to minimize the incidence and severity of erectile dysfunction.


RESULTS
Contemporary approaches to penile rehabilitation include oral phosphodiesterase type-5 inhibitors, vacuum constriction devices, intracavernous vasoactive injections and attempts at frequent sexual encounters. The intent of penile rehabilitation strategies is to facilitate the recovery of erectile function through preservation of cavernous smooth muscle, though none has definitive evidence of benefit.


CONCLUSIONS
This review will evaluate the current theories of the cause of postprostatectomy erectile dysfunction, alterations in surgical technique to minimize it, and the application of erectogenic pharmaceuticals to improve recovery of erectile function, or maximize its preservation. A discussion of basic science evidence and clinical trials will be reviewed.
London Health Sciences Centre, Division of Urology, Canada bSchulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.
Francisco Javier
FJ
Garcia
Gerald
G
Brock
D007172:Erectile Dysfunction / Q000209:etiology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000601:surgery*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use
D010726:Phosphodiesterase Inhibitors; D014665:Vasodilator Agents