Schover L R
Cancer. 1987 Aug 1;60(3 Suppl):553-8. doi: 10.1002/1097-0142(19870801)60:3+<553::aid-cncr2820601519>3.0.co;2-3.
With the advent of effective treatment for urologic cancer, the preservation of sexual function and fertility has become an important goal. Some cancer treatments damage the physiological systems involved in reproduction. All have a psychological impact on sexuality. For men with prostate cancer, current issues in sexual rehabilitation include the debate on nerve-sparing radical prostatectomy, the role of vascular damage in causing erectile dysfunction after radiotherapy, and the need for a better understanding of hormonal effects on central and peripheral mechanisms of sexual function. In the treatment of men and women with bladder cancer, the sexual function morbidity of radical cystectomy is described in data from prospective interview studies. Sexual desire and orgasm remain normal after surgery despite disruption of the genital vasocongestion accompanying sexual arousal. Long-term follow-up studies of testicular cancer patients suggest that some increase in sexual dysfunction does occur. Infertility remains a concern for a subgroup of younger, childless men. Attempts to modify or eliminate retroperitoneal lymphadenectomy are discussed, as is recovery of spermatogenesis after chemotherapy and radiotherapy. Sexual function in patients with penile, urethral, or renal cell carcinoma is briefly reviewed.
随着泌尿系统癌症有效治疗方法的出现，性功能和生育能力的保留已成为一个重要目标。一些癌症治疗会损害生殖相关的生理系统。所有这些治疗都会对性功能产生心理影响。对于前列腺癌男性患者，当前性康复方面的问题包括关于保留神经的根治性前列腺切除术的争论、放疗后血管损伤在导致勃起功能障碍中的作用，以及需要更好地理解激素对性功能中枢和外周机制的影响。在膀胱癌男性和女性患者的治疗中，前瞻性访谈研究的数据描述了根治性膀胱切除术的性功能发病率。尽管性唤起时生殖器血管充血受到破坏，但术后性欲和性高潮仍保持正常。睾丸癌患者的长期随访研究表明，性功能障碍确实会有所增加。不育问题仍然是一部分年轻无子女男性所担忧的。文中讨论了改变或消除腹膜后淋巴结清扫术的尝试，以及化疗和放疗后精子发生的恢复情况。还简要回顾了阴茎癌、尿道癌或肾细胞癌患者的性功能。
