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根治性前列腺切除术后的勃起功能保存。

Erectile preservation following radical prostatectomy.

机构信息

Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA.

出版信息

Ther Adv Urol. 2011 Feb;3(1):35-46. doi: 10.1177/1756287211400492.

Abstract

Prostate cancer is the most common cancer among men, representing approximately 25% of all new cancer diagnoses in the USA. For clinically localized prostate cancer, the gold standard for therapy remains radical prostatectomy. One of the main adverse effects of this procedure is erectile dysfunction, which can have a significant impact on the patient's quality of life. There are several mechanisms of erectile dysfunction postprostatectomy, including arteriogenic, venogenic and neurogenic types, as well as the potentially heightened risk of postprostatectomy patients to develop Peyronie's disease. The purpose of this review is to explain the various treatment options available, including phosphodiesterase type 5 inhibitors, intracavernosal injections, intraurethral alprostadil suppositories, vacuum erection devices, and penile prostheses. The role of these therapies in an erectile-dysfunction-treatment function, as well as in penile rehabilitation, will be discussed. Finally, a review of research on novel therapies will also be presented. A comprehensive literature review was performed using the PubMed database. Articles were chosen based on topical relevance and assessed for methodology and major findings. There are data to support the use of each of the therapeutic options in both treatment and rehabilitative roles. More study is needed, however, specifically in regard to penile rehabilitation, to confirm its benefits, as well as to determine optimal rehabilitation protocols.

摘要

前列腺癌是男性中最常见的癌症,约占美国所有新发癌症诊断的 25%。对于临床局限性前列腺癌,治疗的金标准仍然是根治性前列腺切除术。这种手术的主要不良后果之一是勃起功能障碍,这会对患者的生活质量产生重大影响。前列腺切除术后勃起功能障碍有多种机制,包括动脉性、静脉性和神经性,以及前列腺切除术后患者发生佩罗尼病的潜在风险增加。本文的目的是解释现有的各种治疗选择,包括磷酸二酯酶 5 抑制剂、海绵体内注射、尿道内前列地尔栓剂、真空勃起装置和阴茎假体。将讨论这些治疗方法在勃起功能障碍治疗中的作用,以及在阴茎康复中的作用。最后,还将对新型治疗方法的研究进行综述。使用 PubMed 数据库进行了全面的文献综述。根据主题相关性选择文章,并评估其方法和主要发现。有数据支持每种治疗选择在治疗和康复角色中的应用。然而,还需要更多的研究,特别是在阴茎康复方面,以确认其益处,并确定最佳的康复方案。

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