Erectile dysfunction following radical retropubic prostatectomy: Epidemiology, pathophysiology and pharmacological management

Kalyana C. Nandipati, Rupesh Raina, Ashok Agarwal, Craig D. Zippe

Research output: Contribution to journalReview article

40 Citations (Scopus)

Abstract

Radical prostatectomy has been the time-honoured and standard treatment option for prostate cancer. Erectile dysfunction (ED) is one of the common quality-of-life issues following radical prostatectomy. The recovery of potency following radical prostatectomy varies from 16% to 86%. Although major modifications in surgical technique appear to be promising, the reported ED rates are still high. The time period required for the recovery of erectile function after surgery varies from 6 to 24 months. During this period of neuropraxia lack of natural erections produces cavernosal hypoxia. This cavernosal hypoxia has been implicated as one of the most important factors in the pathophysiology of ED. Cavernosal hypoxia predisposes to cavernosal fibrosis, ultimately producing venous leak and long-term ED. Interruption of this cascade of events has been the major challenge for physicians. Physicians have several options available for the treatment of ED. However, oral treatment options have quickly become established as first-line treatment options. Sildenafil has been most extensively studied in the radical prostatectomy population. In patients who do not respond to oral therapy alone, standard treatment options (intracavernosal injections, vacuum constriction devices and intraurethral alprostadil) are useful. Use of penile prostheses is one of the oldest treatment options available for the treatment of ED but is used only as a last resort. Initial attempts to promote the earlier recovery of erectile function appear to be promising. However, further confirmatory studies are essential. The roles of gene transfer and growth factors are still in experimental stages. In this review we discuss the epidemiology, pathophysiology and treatment options available for ED following radical prostatectomy.

Original languageEnglish
Pages (from-to)101-117
Number of pages17
JournalDrugs and Aging
Volume23
Issue number2
DOIs
StatePublished - 2006
Externally publishedYes

Fingerprint

Erectile Dysfunction
Prostatectomy
Epidemiology
Pharmacology
Therapeutics
Recovery of Function
Penile Prosthesis
Physicians
Transfer Factor
Alprostadil
Vacuum
Constriction
Prostatic Neoplasms
Intercellular Signaling Peptides and Proteins
Fibrosis
Quality of Life
Equipment and Supplies
Injections

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Geriatrics and Gerontology

Cite this

Erectile dysfunction following radical retropubic prostatectomy : Epidemiology, pathophysiology and pharmacological management. / Nandipati, Kalyana C.; Raina, Rupesh; Agarwal, Ashok; Zippe, Craig D.

In: Drugs and Aging, Vol. 23, No. 2, 2006, p. 101-117.

Research output: Contribution to journalReview article

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