title: Development of UK guidance on the management of erectile dysfunction resulting from radical radiotherapy and androgen deprivation therapy for prostate cancer.
abstract: OBJECTIVE
  To develop a management strategy (rehabilitation programme) for erectile dysfunction (ED) after radiotherapy (RT) or androgen deprivation therapy (ADT) for prostate cancer that is suitable for use in a UK NHS healthcare context.
  
  
  METHODS
  PubMed literature searches of ED management in this patient group together with a survey of 28 experts in the management of treatment-induced ED from across the UK were conducted.
  
  
  RESULTS
  Data from 19 articles and completed questionnaires were collated. The findings discussed in this article confirm that RT/ADT for prostate cancer can significantly impair erectile function. While many men achieve erections through PDE5-I use, others need combined management incorporating exercise and lifestyle modifications, psychosexual counselling and other erectile aids. This article offers a comprehensive treatment algorithm to manage patients with ED associated with RT/ADT.
  
  
  CONCLUSIONS
  Based on published research literature and survey analysis, recommendations are proposed for the standardisation of management strategies employed for ED after RT/ADT. In addition to implementing the algorithm, understanding the rationale for the type and timing of ED management strategies is crucial for clinicians, men and their partners.
authors.affiliation: Urology Unit, The Royal Marsden NHS Foundation Trust, London & Sutton, UK.
authors.forename: I D
authors.initials: ID
authors.lastname: White
authors.forename: J
authors.initials: J
authors.lastname: Wilson
authors.forename: P
authors.initials: P
authors.lastname: Aslet
authors.forename: A B
authors.initials: AB
authors.lastname: Baxter
authors.forename: A
authors.initials: A
authors.lastname: Birtle
authors.forename: B
authors.initials: B
authors.lastname: Challacombe
authors.forename: J
authors.initials: J
authors.lastname: Coe
authors.forename: L
authors.initials: L
authors.lastname: Grover
authors.forename: H
authors.initials: H
authors.lastname: Payne
authors.forename: S
authors.initials: S
authors.lastname: Russell
authors.forename: V
authors.initials: V
authors.lastname: Sangar
authors.forename: N
authors.initials: N
authors.lastname: Van As
authors.forename: M
authors.initials: M
authors.lastname: Kirby
mesh_terms: D000726:Androgen Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects; D007172:Erectile Dysfunction / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D011471:Prostatic Neoplasms / Q000188:drug therapy; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects*; D006113:United Kingdom
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal