Penile rehabilitation and cancer spread

Abstract

Full Text: cer progression in prospective studies that used PDE5I for the purpose of penile rehabilitation after radical prostatectomy. By using data up to December 2014 from PubMed, Embase, and the Cochrane Library, a search was performed for prospective case-control studies evaluating the effects of PDE5I intake after radical prostatectomy on erectile dysfunction. From the selected studies, comparisons were made according to the surgical method for prostate cancer, the type and administration method of PDE5I, the method for evaluating erectile functionality, and adverse events (Gallina et al., 2015; Li et al., 2014; Vehmas, 2015) . All 15 randomized prospective studies investigated nerve-sparing radical prostatectomy patients; in 12 studies, the patients underwent bilateral nerve-sparing surgery and in three studies, the patients underwent unilateral nerve sparing. In terms of the type of PDE5I, sildenafil was used in seven studies, tadalafil was used in seven, and vardenafil was used in one. In 11 of the studies, patients were administered PDE5I every day after nerve-sparing radical prostatectomy, and in four studies patients were only administered PDE5I as needed. Questionnaires used to assess erectile function included the International Index of Erectile Function (IIEF), the Sexual Encounter Profile, the Sexual Health Inventory for Men, and the Erectile Dysfunction Inventory of Treatment Satisfaction. The IIEF was used in all but two studies, either by itself or together with other instruments. Complications after the administration of PDE5I were observed in seven of the 15 studies, and these were mild complications such as headaches, indigestion, hot flashes, and nasopharyngitis. The remaining six studies did not include information on safety and complications of PDE5I intake after surgery. There were no studies that reported follow-up monitoring of prostate cancer after radical prostatectomy. Studies to date have only focused on the therapeutic effects of PDE5I in restoring erectile functionality, and studies on the effects of PDE5I on prostate cancer are lacking. It is currently not possible to per-form a meta-analysis. Therefore, there is a need for further prospective case-control studies on the association of biochemical recurrence of prostate cancer with the intake of PDE5I after radical prostatectomy. Next year, JER aims to look even closer at rehabilitation-related assessments from different academic perspectives and to introduce these interests to readers.