Shu Tung, Ren Danqing, Wang Run
Division of Urology, University of Texas McGovern Medical School, Houston, TX, USA.
Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Int J Impot Res. 2025 May 29. doi: 10.1038/s41443-025-01092-9.
Radical prostatectomy (RP) is a common treatment for localized prostate cancer, which unfortunately often results in sexual dysfunction, including, but not limited to erectile dysfunction (ED), penile atrophy and penile fibrosis. Various therapies have been used to manage these side effects associated with RP, including vacuum erection devices (VEDs) and penile traction therapy (PTT). This review focuses on the mechanisms, efficacy, and clinical applications of VED and PTT in post-RP patients. VED, a well-established, non-invasive modality, enhances penile blood flow, preserves tissue integrity, and facilitates early engagement in sexual activity. Although VED has been shown to help maintain penile length and improve sexual function, its effectiveness in accelerating spontaneous erectile function recovery remains uncertain. PTT, originally developed for Peyronie's disease, has recently been explored for post-RP patients. Preliminary studies suggest its potential in mitigating penile shortening and supporting functional recovery, though long-term efficacy data remain limited. Both therapies face challenges, including lack of standardized protocols, adherence issues, and encouraging, but limited evidence on their combined use with pharmacological interventions. Additionally, factors such as patient education, treatment accessibility, and psychological support play critical roles in therapy adherence and overall success. Further research is needed to optimize treatment protocols, improve patient compliance, and establish the role of VED and PTT in comprehensive post-RP care through large-scale, well-designed clinical trials.
根治性前列腺切除术（RP）是局限性前列腺癌的常见治疗方法，但不幸的是，它常常导致性功能障碍，包括但不限于勃起功能障碍（ED）、阴茎萎缩和阴茎纤维化。人们已经使用了各种疗法来处理与RP相关的这些副作用，包括真空勃起装置（VED）和阴茎牵引疗法（PTT）。这篇综述聚焦于VED和PTT在RP术后患者中的作用机制、疗效及临床应用。VED是一种成熟的非侵入性方法，可增加阴茎血流量，保持组织完整性，并促进早期进行性活动。尽管VED已被证明有助于维持阴茎长度并改善性功能，但其在加速自发性勃起功能恢复方面的有效性仍不确定。PTT最初是为佩罗尼氏病开发的，最近已在RP术后患者中进行探索。初步研究表明其在减轻阴茎缩短和支持功能恢复方面具有潜力，不过长期疗效数据仍然有限。这两种疗法都面临挑战，包括缺乏标准化方案、依从性问题，以及关于它们与药物干预联合使用的证据虽令人鼓舞但有限。此外，患者教育、治疗可及性和心理支持等因素在治疗依从性和总体成功率方面起着关键作用。需要通过大规模、精心设计的临床试验进行进一步研究，以优化治疗方案，提高患者依从性，并确定VED和PTT在RP术后综合护理中的作用。
