Efficacy of a preprostatectomy multi-modal penile rehabilitation regimen on recovery of postoperative erectile function

Osadchiy, Vadim; Jiang, Tommy; Mills, Steven A.; Pollard, Matthew; Reiter, Robert E.; Mills, Jesse N.

doi:10.1038/s41443-019-0187-y

Cited by 18 publications

(16 citation statements)

References 14 publications

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“…We screened 92 studies and included five of them that met the inclusion criteria: four RCTs (13-16) and one retrospective comparative study (17), published between 2015 and 2020. The diagram of the studies' selection is displayed in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…One study protocol was based on a combination of oral therapy, lifestyle counseling, and the continuous use of a vacuum device. Intervention group received 5 mg of tadalafil daily and 1,500 mg of L-citrulline twice daily, + lifestyle counseling 2 weeks before RP, and vacuum daily initiated 1 month post-RP (17).…”

Section: Resultsmentioning

confidence: 99%

“…Surgical technique of RP was not mentioned in the studies by Chambers and Lira (13,14 Follow-up ranged between 3 and 12 months. Sexual outcomes were assessed by the International Index of Erectile F unction (IIEF) in one study (13), the short form 5-item IIEF (IIEF-5) in three studies (14)(15)(16), question 2 and 3 of the sexual encounter profile (SEP) questionnaire in one study (17), and EF domain of the Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP) in one study (16). In the study by Chambers et al based on the counseling protocol, psychological scale and couple's assessment were also used.…”

Section: Resultsmentioning

confidence: 99%

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Is it Worth Starting Sexual Rehabilitation Before Radical Prostatectomy? Results From a Systematic Review of the Literature

et al. 2021

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Background and Purpose: Sexual dysfunction (SD) is a frequent side effect associated with radical prostatectomy (RP) for prostate cancer (PCa). Some studies have showed the benefit associated with preoperative sexual rehabilitation (prehabilitation) and Enhanced Recovery After Surgery (ERAS) for RP, but no clear clinical recommendations are available yet. Our aim was to conduct a systematic review on sexual prehabilitation prior to RP for patients with a localized PCa and analyze the impact on postoperative sexual health compared with the standard post-operative care.Methods: We performed a systematic review of the literature following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) recommendations.Results: Four randomized control trials and one retrospective comparative study were included in the analyses. Three of the five studies showed an improved EF recovery post-RP in the prehabilitation group compared to the standard of care represented by: higher International Index of Erectile Function 5 score (IIEF5) or IIEF score (p < 0.0001) and a higher percentage of patients reporting return of EF based on the Sexual Encounter Profile (SEP) (56 vs. 24%, p = 0.007). Self-confidence, therapeutic alliance, and adherence to treatment were stronger for patients with preoperative consultations (p < 0.05) and EF recovery was better in cases of a higher number of follow-up visits (OR 4–5 visits vs. 1:12.19, p = 0.002).Discussion: Despite heterogenous methods and high risks of bias in this systematic review, starting sexual rehabilitation prior to surgery seems to ensure better EF recovery. This prehabilitation should include information of both the patient and his or her partner, with a closer follow up and the use of a multimodal treatment approach that still remains to be defined and validated (oral medication, vacuum devices, pelvic floor muscle training, etc.).

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Is it Worth Starting Sexual Rehabilitation Before Radical Prostatectomy? Results From a Systematic Review of the Literature

et al. 2021

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“…[ 1 ], However, the nerve injury after RP inhibits the NO/cGMP signal pathway. The treatment effect of first-line drug PDE5i is poor, other treatments are cumbersome, or patients’ compliance is lacking [ 2 ]. Therefore, we urgently need new and effective methods.…”

Section: Introductionmentioning

confidence: 99%

A new strategy for stem cells therapy for erectile dysfunction: Adipose-derived stem cells transfect Neuregulin-1 gene through superparamagnetic iron oxide nanoparticles

et al. 2022

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Purpose Our previous studies showed that nanotechnology improves derived adipose-derived stem cells (ADSCs) therapy for erectile dysfunction (ED). In this study, the Neuregulin-1(NRG1) gene was transfected into ADSCs with superparamagnetic iron oxide nanoparticles (SPION) further to improve the therapeutic effect of ADSCs on ED. Materials and Methods ADSCs were isolated from epididymal adipose tissue of Sprague–Dawley rats. The optimal concentration of PEI-SPION (SPION modified with polyethyleneimine) was selected to construct the gene complex. After electrostatic binding of PEI-SPION and DNA, a PEI layer was wrapped to make the PEI-SPION-NRG1-PEI gene transfection complex. Different groups were set up for transfection tests. Lipo2000 transfection reagent was used as the control. PEI-SPION-NRG1-PEI in the experimental group was transfected under an external magnetic field. Results When the concentration of PEI-SPION was 10 µg/mL, it had little cytotoxicity, and cell activity was not significantly affected. PEI-SPION-NRG1-PEI forms positively charged nanocomposites with a particle size of 72.6±14.9 nm when N/P ≥8. The PEI-SPION-NRG1-PEI gene complex can significantly improve the transfection efficiency of ADSCs, reaching 26.74%±4.62%, under the action of the external magnetic field. PCR and Western blot showed that the expression level of the NRG1 gene increased significantly, which proved that the transfection was effective. Conclusions PEI-SPION can be used as a vector for NRG1 gene transfection into ADSCs. PEI-SPION-NRG1-PEI packaging has the highest transfection efficiency under the external magnetic field than the other groups. These findings may provide a new strategy for ADSCs therapy for ED.

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“…The actual state-of-the-art recommendations in post RP ED management reports that (a) administration of PDE5 is vaccum erection devices and intracorporeal injections are equally effective treatments; (b) whatever treatment is undertaken, it is better to initiate it as close as possible from surgery ( Bratu et al, 2017 ; Liu et al, 2017 ; Schoentgen et al, 2021 ); (c) in case of refractory ED, penile prosthesis implant is an effective and satisfactory alternative ( Lima et al, 2020 ); and (d) yet no proper algorithm or specific regimen is established as optimal ( Salonia et al, 2017 ). Lately, few trials assessed more comprehensive and multimodal rehabilitation programs, including psychological intervention and sexual counseling ( Matthew et al, 2018 ; Osadchiy et al, 2020 ), but those are scares and yet to be disseminate in the common practice, whereas patients’ needs stay considerable and unsatisfied ( Giuliano et al, 2008 ).…”

Section: Introductionmentioning

confidence: 99%

Patient Education for Radical Prostatectomy: Development of a Program Tailored to the Needs of Prostate Cancer Patients

et al. 2021

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In all, 30% to 90% of prostate cancer patients undergoing radical prostatectomy (RP) recover their erectile capacity. No effective post RP erectile rehabilitation program exists to date. The aim of this exploratory qualitative study is to explore the needs of these patients and to develop a patient education program (PEP) which meets these needs. Interviews were carried out by a socio-anthropologist with prostate cancer patients treated by RP within the 6 previous months. The needs and expectations identified led to the choice of a logical model of change for the construction of the PEP. Nineteen patients were included in the study; 17 of them were living with a partner. Two categories of patients appeared during the interviews: informed patients resigned to lose their sexuality and patients misinformed about the consequences of the surgery. The tailored program was built on the Health Belief Model and provides six individual sessions, including one with the partner, to meet the needs identified. This study designed the first program to target comprehensively the overall sexuality of the patient and his partner, and not only erection issues. To demonstrate the effectiveness of this program, a controlled, multicentric clinical trial is currently ongoing.

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Efficacy of a preprostatectomy multi-modal penile rehabilitation regimen on recovery of postoperative erectile function

Cited by 18 publications

References 14 publications

Is it Worth Starting Sexual Rehabilitation Before Radical Prostatectomy? Results From a Systematic Review of the Literature

Is it Worth Starting Sexual Rehabilitation Before Radical Prostatectomy? Results From a Systematic Review of the Literature

A new strategy for stem cells therapy for erectile dysfunction: Adipose-derived stem cells transfect Neuregulin-1 gene through superparamagnetic iron oxide nanoparticles

Patient Education for Radical Prostatectomy: Development of a Program Tailored to the Needs of Prostate Cancer Patients

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