Penile rehabilitation in patients after radical prostatectomy

Introduction. Prostate cancer (PCa) is one of the most common cancers in men. Radical prostatectomy (RP) is one of the main treatment modalities for localized PCa. Erectile dysfunction (ED), being a consequence of surgical treatment, can have detrimental effects on both physical health and psychosocial status and significantly impair the quality of life of patients and their partners. The risk of ED in the postoperative period in patients undergoing RP, according to the modern literature, is about 60-70%. Materials and methods. The paper describes in detail the pathogenesis of ED after RP. The main components of penile rehabilitation (PR) and their mechanism of action are described, literature data confirming their effectiveness is presented. Results. Currently, after nerve-sparing radical prostatectomy, the following penile rehabilitation methods are used - the use of inhibitors of PDE-5 type, shock wave therapy, vacuum erection therapy (VED), intracavernous injections, penile prosthetics and a combination of these methods. Combined rehabilitation programs promote EF recovery after RP with better results compared to monotherapy. Conclusion. We see a perspective in the development of combined approach strategies for the rehabilitation of erectile funktion (EF) after RP. Further improvement of the surgical technique of nerve-sparing RP, as well as a deeper understanding of the implementation of the postoperative process is crucial to develop an algorithm for the EF restoration program.