Current Strategies to Improve Erectile Function in Patients Undergoing Radical Prostatectomy - Postoperative Scenario - Beyond the Abstract

Erectile function (EF) after radical prostatectomy is influenced by physiologic, hormonal and psychosocial aspects. Therefore, it is important to integrate a multidisciplinary team to successfully address the challenges of penile rehabilitation.

We propose different strategies to improve EF in this scenario. For instance, early pharmacological and mechanical interventions seem to be beneficial approaches to avoid fibrosis in the corpora cavernosa and promote faster recovery. On the other hand, the assessment of psychosocial health and implementation of cognitive-behavioral therapies are explored in our review since patients may experience depression, stress, and anxiety, which are related to proinflammatory cytokine production and worse outcomes in the transoperative period. In addition, strategies aimed at optimizing the metabolic equilibrium, including hormonal evaluation as well as strategies to increase patients’ well-being are included and proposed to be part of rehabilitation protocols. Finally, we discussed exciting therapies related to stimulation of neural regeneration as hyperbaric oxygen, nerve-grafting techniques, stem cells, gene therapy, and extracorporeal shockwave therapy.

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Written by: Adriana M Pedraza, Krunal Pandav, Mani Menon, Mohit Khera, Vinayak Wagaskar, Zachary Dovey, Nihal Mohamed, Sneha Parekh, Ashutosh K Tewari

Department of Urology, Icahn School of Medicine at Mount Sinai, New York City, NY., Scott Department of Urology, Baylor College of Medicine, Houston, TX., Department of Urology, Icahn School of Medicine at Mount Sinai, New York City, NY.

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