Loh-Doyle Jeffrey C
Institute of Urology, USC/Norris Comprehensive Cancer Center, University of Southern California, 1441 Eastlake Avenue, Suite 7416, Los Angeles, CA, 90089-9178, USA.
Curr Urol Rep. 2019 Jan 28;20(2):7. doi: 10.1007/s11934-019-0873-9.
After radical cystoprostatectomy, patients often develop erectile dysfunction refractory to first- and second-line treatments. In this review, we summarize and analyze the literature describing the technical considerations and outcomes of penile implant surgery in bladder cancer patients with history of radical cystectomy and urinary diversion.
Penile prosthesis surgery in patients after radical cystectomy and urinary diversion has been infrequently described in the literature. Recent studies have shown that the three-piece inflatable penile prosthesis can be placed safely after significant prior intraabdominal surgery due to the development and refinement of several techniques to place the reservoir. Further studies are needed to objectively determine the impact of penile prosthetic surgery on functional outcomes in this historically undertreated yet increasingly significant patient population. As health-related quality of life outcomes continue to gain increasing importance after radical cystectomy, urologists should offer motivated bladder cancer survivors the inflatable penile prosthesis as the treatment of choice for refractory erectile dysfunction due to its safety and unmatched ability to restore erectile function.
根治性膀胱前列腺切除术后,患者常出现对一线和二线治疗均无效的勃起功能障碍。在本综述中,我们总结并分析了描述阴茎植入手术在有根治性膀胱切除术和尿流改道病史的膀胱癌患者中的技术要点及结果的文献。
根治性膀胱切除术和尿流改道术后患者的阴茎假体手术在文献中鲜有描述。近期研究表明,由于多种放置贮液囊技术的发展和完善,三件式可膨胀阴茎假体可在既往有重大腹部手术史后安全植入。对于这一历史上治疗不足但日益重要的患者群体,需要进一步研究以客观确定阴茎假体手术对功能结局的影响。随着根治性膀胱切除术后与健康相关的生活质量结局变得越来越重要,泌尿外科医生应向有意愿的膀胱癌幸存者提供可膨胀阴茎假体,作为治疗难治性勃起功能障碍的首选方法,因为其安全性高且恢复勃起功能的能力无与伦比。