title: Sexuality Following Radical Prostatectomy: Is Restoration of Erectile Function Enough?
abstract: BACKGROUND
  Radical prostatectomies can result in urinary incontinence and sexual dysfunction. Traditionally, these issues have been studied separately, and the sexual problem that has received the most focus has been erectile dysfunction.
  
  
  OBJECTIVE
  To summarize the literature on sexually related side effects and their consequences after radical prostatectomy and focus on the occurrence and management of problems beyond erectile dysfunction.
  
  
  METHODS
  The literature on sexuality after radical prostatectomy was reviewed through a Medline search. Original research using quantitative and qualitative methodologies was considered. Priority was given to studies exploring aspects of sexuality other than erectile function.
  
  
  METHODS
  The prevalence, predictive factors, and management of post-prostatectomy sexual problems beyond erectile dysfunction.
  
  
  RESULTS
  Most patients will develop urinary incontinence in relation to sexual activity after surgery. This can present at the time of orgasm (ie, climacturia) or arise during arousal. In general, the problem subsides with time and pelvic floor training and tension penile loops can be used as treatments. Orgasmic disturbances after radical prostatectomy include altered perception of orgasm, anorgasmia, and orgasm-associated pain. The prevalence rates of these problems vary widely among studies but usually decrease with time. Phosphodiesterase type 5 inhibitors can increase orgasmic sensation and α-blockers can alleviate pain. Penile shortening and de novo deformity have been described; more research on their clinical impact is needed. When evaluating any of the problems mentioned, psychological factors should be considered and the patient's partner should be involved whenever possible.
  
  
  CONCLUSIONS
  Radical prostatectomies can cause a wide range of sexual problems. Therefore, restoration of erectile function alone is not enough. On the contrary, it is crucial that clinicians focus on patients' full sexual rehabilitation.
authors: Department of Urology, University Hospital of Zealand, Roskilde Hospital, Roskilde, Denmark; Department of Urology, Herlev and Gentofte Hospital, Herlev, Denmark. Electronic address: mikkelfode@gmail.com.
authors: Mikkel
authors: M
authors: Fode
authors: Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey.
authors: Ege C
authors: EC
authors: Serefoglu
authors: Department of Urology, University Hospitals Leuven, Leuven, Belgium.
authors: Maarten
authors: M
authors: Albersen
authors: Department of Urology, Herlev and Gentofte Hospital, Herlev, Denmark.
authors: Jens
authors: J
authors: Sønksen
keywords: Climacturia; Erectile Dysfunction; Orgasmic Dysfunction; Prostate Cancer; Radical Prostatectomy; Sexuality