Department of Urology, University Hospitals Leuven, Leuven, Belgium.
Laboratory for Experimental Urology, Organ systems, Department of Development and Regeneration, University of Leuven, Leuven, Belgium.
Int J Impot Res. 2021 May;33(4):448-456. doi: 10.1038/s41443-021-00420-z. Epub 2021 Mar 22.
Erectile dysfunction is commonly reported after radical prostatectomy. Besides the loss of erections, sexual life after prostatectomy is impacted by urinary incontinence, orgasmic dysfunction, and psychological stress. In this review, we describe classical medical therapies used for erectile function rehabilitation such as PDE5 inhibitors and injection therapy. A vast amount of data support the idea of focusing on restoration of sexual function on top of erectile function after prostatectomy. The important strategies described to rehabilitate sexual function include pelvic floor muscle therapy, couple therapy, appropriate preoperative counseling, and focusing on non-penetrative alternatives. A multidisciplinary approach and including the partner is important. Erectile function alone is not sufficient for satisfactory sexual experience and may not be used as a proxy for sexual quality of life. Adding full-spectrum sexual rehabilitation to a standard penile rehabilitation regimen has the highest chances of obtaining satisfactory sexual outcomes in men and their partners after radical prostatectomy.
勃起功能障碍是前列腺根治术后常见的并发症。除了勃起功能丧失外，前列腺切除术后的性生活还会受到尿失禁、性高潮功能障碍和心理压力的影响。在这篇综述中，我们描述了用于勃起功能康复的经典医学治疗方法，如 PDE5 抑制剂和注射治疗。大量数据支持在前列腺切除术后除了关注勃起功能外，还应关注性功能的恢复。描述的恢复性功能的重要策略包括盆底肌肉治疗、夫妻治疗、适当的术前咨询以及关注非渗透替代方法。多学科方法和包括伴侣在内都很重要。勃起功能本身不足以获得满意的性体验，也不能作为性生活质量的替代指标。在标准阴茎康复方案中加入全谱性功能康复，可以使男性及其伴侣在接受前列腺根治术后获得满意的性结果的机会最大。
