Management of erectile dysfunction after radical prostatectomy
© Springer-Verlag London 2015. Erectile dysfunction (ED) is one of the most common sequelae after radical prostatectomy for organ-confined prostate cancer. Despite nerve-sparing techniques, surgical neurovascular injury occurs and subsequent cessation of erections leads to significant cavernosal hypoxia with attendant microstructural consequences and severe impairment of erectile function (EF). Pharmacological strategies for rehabilitation of natural EF using on demand or daily phosphodiesterase type 5-inhibitors (PDE5i) have not proven to positively impact the return of unassisted EF in randomized controlled trials. However, treatment-options for ED are available including oral, intracavernosal, or intraurethral therapy, vacuum devices, and ultimately penile implant surgery.
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