Droupy S, Al Said B, Lechevallier E, Colson M-H, Giuliano F
Service d'urologie andrologie, CHU de Nîmes, place du Professeur-Robert-Debré, 30029 Nîmes cedex 09, France.
Prog Urol. 2013 Jul;23(9):696-711. doi: 10.1016/j.purol.2013.03.011. Epub 2013 May 31.
All treatments for prostate cancer have a negative impact on sexuality. The objective of this review is to highlight recent developments in the management of sexual dysfunction associated with prostate cancer.
We performed a literature search in the Pubmed database to select relevant articles.
There is a specific profile of changes in the fields of sexual, urinary, bowel and general quality of life, according to the treatment modalities chosen. Maintenance of a satisfying sex life is a major concern of a majority of men facing prostate cancer and its treatments. It is essential to assess the couple's sexuality before treating prostate cancer in order to deliver comprehensive information and consider early therapeutic solutions adapted to the couple's expectations. The results of randomized studies show that robotic radical prostatectomy allows a faster recovery of natural erections compared to classic laparoscopy. Active pharmacological erectile rehabilitation (intracavernous injections or phosphodiesterase type 5 inhibitors [PDE5i] on demand, during the month following surgery) or passive (daily PDE5i after surgery) might improve the quality of erections especially in response to PDE5i. Unimpaired aspects of sexual response (orgasm) may, when the erection is not yet recovered, represent an alternative allowing the couple to preserve intimacy and complicity. Androgen blockade is a major barrier to maintain or return to a satisfying sex.
After the treatment of prostate cancer, one specific support sometimes assisted by networking will optimize satisfying sex life recovery.
前列腺癌的所有治疗方法都会对性功能产生负面影响。本综述的目的是突出前列腺癌相关性功能障碍管理方面的最新进展。
我们在PubMed数据库中进行文献检索以选择相关文章。
根据所选治疗方式的不同,在性、泌尿、肠道及总体生活质量方面存在特定的变化特征。维持满意的性生活是大多数面临前列腺癌及其治疗的男性的主要关注点。在治疗前列腺癌之前评估夫妻的性功能至关重要,以便提供全面信息并考虑早期符合夫妻期望的治疗方案。随机研究结果表明,与传统腹腔镜手术相比,机器人根治性前列腺切除术能使自然勃起恢复得更快。积极的药物性勃起康复治疗(术后一个月内按需进行海绵体内注射或使用5型磷酸二酯酶抑制剂[PDE5i])或被动治疗(术后每日使用PDE5i)可能会改善勃起质量,尤其是对PDE5i有反应时。当勃起尚未恢复时,性反应未受影响的方面(性高潮)可能为夫妻维持亲密关系提供一种选择。雄激素阻断是维持或恢复满意性生活的主要障碍。
前列腺癌治疗后,有时通过建立网络提供的特定支持将优化满意性生活的恢复。