title: Sexual Rehabilitation After Treatment for Prostate Cancer-Part 1: 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 prevention and management strategies for post-RP erectile function impairment in terms of preoperative patient characteristics and intraoperative factors that could influence erectile function recovery.
  
  
  METHODS
  A literature search was performed using Google and PubMed databases for English-language original and review articles published up to August 2016.
  
  
  METHODS
  Levels of evidence (LEs) and grades of recommendations (GRs) 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 1 states that clinicians should discuss the occurrence of postsurgical erectile dysfunction (temporary or permanent) with every candidate for RP (expert opinion, clinical principle). Recommendation 2 states that validated instruments for assessing erectile function recovery such as the International Index of Erectile Function and Expanded Prostate Cancer Index Composite questionnaires are available to monitor EF recovery after RP (LE = 1, GR = A). Recommendation 3 states there is insufficient evidence that a specific surgical technique (open vs laparoscopic vs robot-assisted radical prostatectomy) promotes better results in postoperative EF recovery (LE = 2, GR = C). Recommendation 4 states that recognized predictors of EF recovery include but are not limited to younger age, preoperative EF, and bilateral nerve-sparing surgery (LE = 2, GR = B). Recommendation 5 states that patients should be informed about key elements of the pathophysiology of postoperative erectile dysfunction, such as nerve injury and cavernous venous leak (expert opinion, clinical principle).
  
  
  CONCLUSIONS
  This article discusses Recommendations 1 to 5 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 1: Recommendations From the Fourth International Consultation for Sexual Medicine (ICSM 2015). J Sex Med 2017;14:285-296.
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: Erectile Function; Laparoscopic; Nerve Sparing; Prostate Cancer; Radical Prostatectomy; Rehabilitation; Robotic