Department of Urology, Herlev University Hospital, Herlev, Denmark.
BJU Int. 2013 Nov;112(7):998-1008. doi: 10.1111/bju.12228. Epub 2013 Jul 4.
The pathophysiology of erectile dysfunction after radical prostatectomy (RP) is believed to include neuropraxia, which leads to temporarily reduced oxygenation and subsequent structural changes in penile tissue. This results in veno-occlusive dysfunction, therefore, penile rehabilitation programmes focus on tissue oxygenation. Animal studies support the use of phosphodiesterase type 5 inhibitors (PDE5Is) after cavernous nerve damage but results from human studies are contradictory. The largest study to date found no long-term effect of either daily or on-demand PDE5I administration after RP compared with placebo. The effects of prostaglandin and vacuum erection devices are questionable and high-quality studies are lacking. Better documentation for current penile rehabilitation and/or better rehabilitation protocols are needed. One must be careful not to repeat the statement that penile rehabilitation improves erectile function after RP so many times that it becomes a truth even without the proper scientific backing.
根治性前列腺切除术（RP）后勃起功能障碍的病理生理学被认为包括神经损伤，这导致阴茎组织的氧合暂时减少和随后的结构变化。这导致静脉阻塞性功能障碍，因此，阴茎康复方案侧重于组织氧合。动物研究支持在海绵体神经损伤后使用磷酸二酯酶 5 抑制剂（PDE5Is），但来自人体研究的结果却存在矛盾。迄今为止最大的研究发现，与安慰剂相比，RP 后每日或按需给予 PDE5I 治疗与长期疗效无关。前列腺素和真空勃起装置的作用尚不确定，缺乏高质量的研究。目前需要更好地记录阴茎康复情况和/或制定更好的康复方案。人们必须小心，不要在没有适当的科学依据的情况下，多次重复“阴茎康复可以改善 RP 后的勃起功能”的说法，以免使其成为事实。
