Department of Urology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy.
Department of Urology, San Donato Hospital, Arezzo, Italy.
Andrologia. 2022 Oct;54(9):e14506. doi: 10.1111/and.14506. Epub 2022 Jul 3.
We aimed to analyse the current trend of erectile rehabilitation (ER) following radical prostatectomy (RP) using a dedicated survey. An online survey was developed between July and September 2020, aiming to evaluate the ER protocols after RP in daily practice among urologists, andrologists, sexual medicine specialists and residents. We investigated demographics data, type of RP performed, and type, schedule, timing and duration of ER protocols. In total, 518 responders from 52 countries completed the survey. Surgical techniques reported were: 38.9% open, 22.9% laparoscopic and 38.2% robot-assisted RP. 33% of the responders begin ER at the catheter removal, 22% 1 month after surgery and 15% before surgery. Phosphodiesterase inhibitors were the most used medication as first-line treatment (99.4%). Tadalafil 20 mg was the most prescribed, and used daily in 48.2% of the cases, and 2-3 times/week in 46%. Intra-cavernosal injection of prostaglandin E1 was the second most common prescribed monotherapy (67.9%) followed by the association of phosphodiesterase inhibitors and vacuum-erection device (29.6%). The duration of ER was <6 months in 16.2%, between 6 and 11 months in 39%, between 12 and 18 months in 31.9%, between 19-24 months in 9.2% and >24 months in 3.7%. This study showed that the approach to ER after RP was inhomogeneous. International guidelines are urgently needed to standardise ER protocols.
我们旨在通过专门的调查分析根治性前列腺切除术（RP）后勃起功能康复（ER）的当前趋势。2020 年 7 月至 9 月期间进行了在线调查，旨在评估泌尿科医师、男科医师、性医学专家和住院医师在日常实践中 RP 后的 ER 方案。我们调查了人口统计学数据、RP 类型，以及 ER 方案的类型、时间表、时机和持续时间。共有来自 52 个国家的 518 名受访者完成了调查。报告的手术技术包括：38.9%开放式、22.9%腹腔镜和 38.2%机器人辅助 RP。33%的受访者在导管拔除时开始 ER，22%在手术后 1 个月开始，15%在手术前开始。磷酸二酯酶抑制剂是作为一线治疗的最常用药物（99.4%）。他达拉非 20mg 是最常开的处方，48.2%的病例每天使用，46%的病例每周使用 2-3 次。前列腺素 E1 腔内注射是第二种最常开的单药治疗（67.9%），其次是磷酸二酯酶抑制剂和真空勃起装置的联合应用（29.6%）。ER 的持续时间<6 个月的占 16.2%，6-11 个月的占 39%，12-18 个月的占 31.9%，19-24 个月的占 9.2%，>24 个月的占 3.7%。这项研究表明，RP 后 ER 的方法并不统一。迫切需要国际指南来规范 ER 方案。
