title: Sexual Rehabilitation After Treatment For Prostate Cancer-Part 2: Recommendations From the Fourth International Consultation for Sexual Medicine (ICSM 2015).
abstract: BACKGROUND
  Sexual dysfunction is common in patients after radical prostatectomy (RP) for prostate cancer.
  
  
  OBJECTIVE
  To provide the International Consultation for Sexual Medicine (ICSM) 2015 recommendations concerning management strategies for post-RP erectile function impairment and to analyze post-RP sexual dysfunction other than erectile dysfunction.
  
  
  METHODS
  A literature search was performed using Google and PubMed database for English-language original and review articles published up to August 2016.
  
  
  METHODS
  Levels of evidence (LEs) and grades of recommendations (GRs) are provided based on a thorough analysis of the literature and committee consensus.
  
  
  RESULTS
  Nine recommendations are provided by the ICSM 2015 committee on sexual rehabilitation after RP. Recommendation 6 states that the recovery of postoperative erectile function can take several years (LE = 2, GR = C). Recommendation 7 states there are conflicting data as to whether penile rehabilitation with phosphodiesterase type 5 inhibitors improves recovery of spontaneous erections (LE = 1, GR = A). Recommendation 8 states that the data are inadequate to support any specific regimen as optimal for penile rehabilitation (LE = 3, GR = C). Recommendation 9 states that men undergoing RP (any technique) are at risk of sexual changes other than erectile dysfunction, including decreased libido, changes in orgasm, anejaculation, Peyronie-like disease, and changes in penile size (LE = 2, GR = B).
  
  
  CONCLUSIONS
  This article discusses Recommendations 6 to 9 of the ICSM 2015 committee on sexual rehabilitation after RP. Salonia A, Adaikan G, Buvat J, et al. Sexual Rehabilitation After Treatment For Prostate Cancer-Part 2: Recommendations From the Fourth International Consultation for Sexual Medicine (ICSM 2015). J Sex Med 2017;14:297-315.
authors.affiliation: Università Vita-Salute San Raffaele, Milan, Italy. Electronic address: salonia.andrea@hsr.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Salonia
authors.affiliation: Section of Sexual Medicine, Obstetrics and Gynaecology, National University Hospital, National University of Singapore, Singapore.
authors.forename: Ganesh
authors.initials: G
authors.lastname: Adaikan
authors.affiliation: Centre d'études et de traitement de la pathologie de l'appareil reproducteur (CETPARP), Lille, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Buvat
authors.affiliation: Department of Urology, McGill University, Montreal, QC, Canada.
authors.forename: Serge
authors.initials: S
authors.lastname: Carrier
authors.affiliation: Department of Andrology, Sexology and STDs, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Amr
authors.initials: A
authors.lastname: El-Meliegy
authors.affiliation: Second Department of Urology, Aristotle University of Thessaloniki, Pefka Thessaloniki, Greece.
authors.forename: Kostas
authors.initials: K
authors.lastname: Hatzimouratidis
authors.affiliation: Division of Urology, Albany Medical College, Albany, NY, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: McCullough
authors.affiliation: Men's Health Boston and Harvard Medical School, Boston, MA, USA.
authors.forename: Abraham
authors.initials: A
authors.lastname: Morgentaler
authors.affiliation: Centro Universitário UniBH, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Luiz Otavio
authors.initials: LO
authors.lastname: Torres
authors.affiliation: Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Mohit
authors.initials: M
authors.lastname: Khera
mesh_terms: D000368:Aged; D007172:Erectile Dysfunction / Q000517:prevention & control* / Q000534:rehabilitation; D019317:Evidence-Based Medicine; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000502:physiology; D011183:Postoperative Complications / Q000517:prevention & control* / Q000534:rehabilitation; D011184:Postoperative Period; D011468:Prostatectomy / Q000009:adverse effects / Q000534:rehabilitation*; D011471:Prostatic Neoplasms / Q000601:surgery; D020127:Recovery of Function; D012725:Sexual Behavior
keywords: Alprostadil; Climacturia; Erectile Dysfunction; Intracavernosal Injections; Orgasm; Peyronie Disease; Phosphodiesterase Type 5 Inhibitors; Prostate Cancer; Radical Prostatectomy; Rehabilitation; Sexual Desire