Sexual dysfunction is common in patients after radical prostatectomy (RP) for prostate cancer.
To provide the International Consultation for Sexual Medicine (ICSM) 2015 recommendations concerning management strategies for post-RP erectile function impairment and to analyze post-RP sexual dysfunction other than erectile dysfunction.
A literature search was performed using Google and PubMed database for English-language original and review articles published up to August 2016.
Levels of evidence (LEs) and grades of recommendations (GRs) are provided based on a thorough analysis of the literature and committee consensus.
Nine recommendations are provided by the ICSM 2015 committee on sexual rehabilitation after RP. Recommendation 6 states that the recovery of postoperative erectile function can take several years (LE = 2, GR = C). Recommendation 7 states there are conflicting data as to whether penile rehabilitation with phosphodiesterase type 5 inhibitors improves recovery of spontaneous erections (LE = 1, GR = A). Recommendation 8 states that the data are inadequate to support any specific regimen as optimal for penile rehabilitation (LE = 3, GR = C). Recommendation 9 states that men undergoing RP (any technique) are at risk of sexual changes other than erectile dysfunction, including decreased libido, changes in orgasm, anejaculation, Peyronie-like disease, and changes in penile size (LE = 2, GR = B).
This article discusses Recommendations 6 to 9 of the ICSM 2015 committee on sexual rehabilitation after RP. Salonia A, Adaikan G, Buvat J, et al. Sexual Rehabilitation After Treatment For Prostate Cancer-Part 2: Recommendations From the Fourth International Consultation for Sexual Medicine (ICSM 2015). J Sex Med 2017;14:297-315.
The journal of sexual medicine. 2017 Mar [Epub]
Andrea Salonia, Ganesh Adaikan, Jacques Buvat, Serge Carrier, Amr El-Meliegy, Kostas Hatzimouratidis, Andrew McCullough, Abraham Morgentaler, Luiz Otavio Torres, Mohit Khera
Università Vita-Salute San Raffaele, Milan, Italy. Electronic address: ., Section of Sexual Medicine, Obstetrics and Gynaecology, National University Hospital, National University of Singapore, Singapore., Centre d'études et de traitement de la pathologie de l'appareil reproducteur (CETPARP), Lille, France., Department of Urology, McGill University, Montreal, QC, Canada., Department of Andrology, Sexology and STDs, Faculty of Medicine, Cairo University, Cairo, Egypt., Second Department of Urology, Aristotle University of Thessaloniki, Pefka Thessaloniki, Greece., Division of Urology, Albany Medical College, Albany, NY, USA., Men's Health Boston and Harvard Medical School, Boston, MA, USA., Centro Universitário UniBH, Belo Horizonte, Minas Gerais, Brazil., Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA.