Sexual function after male radical cystectomy in a sexually active population

Zippe, Craig D.; Raina, Rupesh; Massanyi, Eric Z.; Agarwal, Ashok; Jones, J. Stephen; Ulchaker, James; Klein, Eric A.

doi:10.1016/j.urology.2004.05.056

Cited by 75 publications

(39 citation statements)

References 19 publications

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“…Several reports published comprised of small number of patients and with limited postoperative follow-up. [35][36][37] Earlier reports defined potency as only 'return of natural erections'; however, more recent reports have defined potency as 'erections sufficient for satisfactory intercourse', a structured definition that explains the low potency rates. The results from the John Hopkins series have not been uniformly confirmed by the other centers of excellence.…”

Section: Ed In Malesmentioning

confidence: 99%

“…In a 5-year interval, we identified 49 preoperative sexually active patients, who underwent RC. 37 These patients completed the International Index of Erectile Function (IIEF-15) before and after surgery (minimum follow-up of 1 year), and after the use of sildenafil citrate or any additional erectaid. At a mean follow-up of 47.6722.7 months, 42 (86%) of the 49 patients were unable to achieve vaginal penetration after surgery.…”

Section: Ed In Malesmentioning

confidence: 99%

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Sexual dysfunction after pelvic surgery

et al. 2005

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Pelvic surgeries are among the most common causes of organic sexual dysfunction in men and women. The impact of nerve-sparing surgery on potency has been well documented in radical prostatectomy. However, its impact on potency needs to be evaluated in other pelvic surgeries. Sexual dysfunction is highly prevalent even after multiple technical advances in the field of oncological surgeries. The prevalence varies from 8 to 82%, depending on the type of pelvic surgery. In females, sexual dysfunction has not been evaluated adequately using validated questionnaires. However, in subspecialized circles, treatment for female sexual dysfunction is becoming routine. Currently, physicians have several options for the treatment of erectile dysfunction (ED) in men. Since the introduction of oral PDE-5 inhibitors, oral therapy has become the first-line treatment option for ED, irrespective of etiology. Currently available treatment options for the female sexual dysfunction include estrogens, androgens, phosphodiesterase inhibitors, and dopamine receptor antagonists. Initial reports regarding the role of early rehabilitation are encouraging and may become the part of routine practice in the management of ED after pelvic surgery. In this article, we summarize the sexual dysfunction following pelvic surgeries and their management. International Journal of Impotence Research (2006) IntroductionErectile dysfunction (ED) is defined as the inability to achieve and maintain an erection sufficient for satisfactory sexual intercourse. 1 Several factors have been implicated in the etiology of ED. Vascular and neurogenic causes are the most common among them. Diabetes, smoking and hypertension are the most important risk factors for vasculogenic sexual dysfunction. Neurological dysfunction is mainly associated with certain neurological syndromes like autonomic neuropathy. Sexual dysfunction after pelvic surgery has been an important and underreported cause of ED. The pathophysiology of sexual dysfunction after pelvic surgery is unique because it can be either vascular or neurogenic factors alone, or a combination of both. The pelvic surgeries in males that are associated with considerable ED include radical prostatectomy (RP), radical cystoprostatectomy (cystectomy) and low anterior or abdominoperineal resections (APRs) for rectal cancer. The pelvic surgeries in females associated with sexual dysfunction include radical cystectomy (RC) for bladder cancer, radical hysterectomy for cancers of the cervix and endometrium and, potentially, simple hysterectomy for benign tumors.In this article, we summarize male and female sexual dysfunction following pelvic surgeries for prostate, bladder and rectal cancer. We also discuss our experience in the treatment of sexual dysfunction following RP and RC. than 10%, urologists still report that the majority of patients experience ED following RRP. [3][4][5] Until recently, ED following RP was not an overwhelming concern, as most prostate cancers were detected in older men. 6 However, since the adven...

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Section: Ed In Malesmentioning

confidence: 99%

Section: Ed In Malesmentioning

confidence: 99%

Sexual dysfunction after pelvic surgery

et al. 2005

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“…Bladder Surgery (eg, radical cystectomy) Zippe et al 22 followed 49 preoperatively potent subjects who had undergone radical cystectomy for 47 months. After surgery, 86% of patients were unable to achieve vaginal penetration, and only 37% of patients who had undergone a nerve-sparing procedure had erections sufficient for vaginal penetration.…”

Section: Pelvic Surgerymentioning

confidence: 99%

Understanding and Managing Erectile Dysfunction in Patients Treated for Cancer

Voznesensky

Annam

Kreder

2016

JOP

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Cancer can cause sexual adverse effects by direct and indirect pathways. It can involve sexual organs, indirectly affect body image, or cause fatigue or depression with subsequent effects on libido. Erectile dysfunction (ED), the inability to obtain or maintain an erection firm enough for sexual intercourse, can also result from adverse effects of cancer treatment, such as fatigue, pain, or anxiety about therapy. In addition, depressed feelings about having cancer can affect sexuality, causing a range of signs and symptoms that can lead to ED. Chemotherapy, hormone therapy, surgery, and radiation can all cause sexual adverse effects. Additional factors that play a role include patient age and degree of ED before starting cancer treatment. In this article, we discuss how chemotherapy, hormone therapy, surgery, and radiation affect erectile function as well as possible treatment options for ED.

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“…Similar to what occurred in PCa, better screening and monitoring protocols for bladder cancer will cause stage migrations and provide earlier indications for RC. 4 …”

Section: Discussionmentioning

confidence: 99%

“…3 During this surgical procedure, the neurovascular bundles (NVBs) are usually removed or damaged, and it results in a dramatic negative impact on many aspects of the quality of life. 4 Hence, the preservation of erectile function (EF) after pelvic urologic surgery still represents a major challenge for most urologists.…”

Section: Introductionmentioning

confidence: 99%

Recovery of erection after pelvic urologic surgery: our experience

et al. 2005

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The incidence of erectile dysfunction (ED) in patients undergoing pelvic urologic surgery, the efficacy and tolerability of vardenafil-based rehabilitative treatment as first option in these patients, the role of spontaneous erection (SE) as a possible positive predictive factor to erection recovery after such treatment, and the role of second-line therapies in those nonresponders are evaluated. All the patients undergoing pelvic urologic surgery at our Institution between November 2002 and December 2003 were considered. Preoperative erectile function (EF) was evaluated by using the abridged five-item version of the International Index of Erectile Function (IIEF5) questionnaire. Study population was divided into separate groups considering grade of preoperative EF, nerve sparing (NS) surgery and type of procedure (radical prostatectomy, radical cystectomy (RC) or nerve and seminal sparing cystectomy). In total, 86 patients were evaluated. After 6 months, an increase in mean IIEF5 score of 12.9 points was found in those who had undergone a bilateral NSRP after vardenafil therapy, of 8.0 points in those who had undergone unilateral NSRP, of 11.3 in those who had undergone NSRC and of 11.5 in nerve and seminal sparing cistectomies. A better vardenafil response was found in patients with SE þ (Po0.001). Among those vardenafil notresponders, 13 were treated by using intracavernous injections, one by vacuum device and three with penile prosthesis implant. In conclusion, in our experience, vardenafil showed to be well tolerated and effective for recovery of EF in patients undergoing pelvic urologic surgery. This drug was particularly effective for those with a normal preoperative EF undergoing an NS procedure. Of course, it should be recognized that the absence of a control group in the study represents an important limitation. However, based on the data from the literature, there is a strong belief that such an approach will lead to an earlier recovery of EF than without rehabilitative treatment.

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Sexual function after male radical cystectomy in a sexually active population

Cited by 75 publications

References 19 publications

Sexual dysfunction after pelvic surgery

Sexual dysfunction after pelvic surgery

Understanding and Managing Erectile Dysfunction in Patients Treated for Cancer

Recovery of erection after pelvic urologic surgery: our experience

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