Possibilities of combined treatment aimed at preservation of sexual function in patients after radical prostatectomy due to localized prostate cancer

Shamin M.V., Kyzlasov P.S., Pomeshkin E.V., Neymark B.A., Pogosyan R.R., Sergeev V.P., Zabelin M.V.

Radical prostatectomy (RPE) is a standard method for treatment of prostate cancer (PC). RPE is followed by a number of complications which significantly lower the quality of life. Among them are erectile dysfunction, penile shortening and curvature.

The aim of the study. Evaluation of the possibilities of combined treatment of sexual dysfunction in patients after RPE due to localized prostate cancer as a factor of improvement of patients’ quality of life.

Materials and methods. The analysis of the effectiveness of different methods aimed at treating sexual dysfunction in patients after RPE was performed. Patients were divided into four groups. Patients from the first group did not undergo procedures for maintaining penile length and prevention of erectile dysfunction. The second group comprised patients who received phosphodiesterase type 5 (PDE5) inhibitors. The third group comprised patients who used penile extenders with glans vacuum fixation. Patients from the fourth group combined the administration of PDE5 inhibitors with the application of penile extenders during three months of the postoperative period.

Results and discussion. The data obtained during the study has convincingly demonstrated not only the possibility of penile length maintenance after RPE by using penile extenders with glans vacuum fixation but also the increase in the length of the penis by 0.75±0.01cm (p<0.05). Patients who regularly received PDE5 inhibitors (II and IV groups) have demonstrated that the incidence of erectile dysfunction during the postoperative period after RPE was lower by 15 and 20%, respectively, in comparison with the control group (p<0.05).

Conclusion. Combined application of PDE5 inhibitors and penile extenders with glans vacuum fiXation lets simultaneously exert influence on the condition of erectile function and on the maintenance of penile length in patients after RPE.

Authors declare lack of the possible conflicts of interests.

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prostate cancer, radical prostatectomy, sexual function, erectile dysfunction