Modern approaches to penile rehabilitation alter radical prostatectomy

Introduction. Currently, despite the availability of a large Arsenal of different ways to treat prostate cancer, radical prostatectomy remains its «gold standard». Erectile dysfunction is one of the most common postoperative complications that significantly reduces the patient's quality of life. Currently, the world is searching for new effective methods of prevention and treatment of this complication. Among Russian urologists, the term «penile rehabilitation» is used to refer to a set of therapeutic measures aimed at restoring erectile function after radical prostatectomy. Despite the large number of publications on this topic, there are currently no unified approaches to its implementation. In this review, we briefly highlighted the main tactical approaches and methods of treatment of erectile dysfunction after radical prostatectomy. Materials and methods. In the search for publications in the databases PubMed and Embase, and in Medline, Google Academy, Scopus using the keywords «prostate cancer», «radical prostatectomy», «erectile dysfunction», «penile rehabilitation». The search was performed without restrictions on the date and language of publications. Only original articles are included in the review. Results. In addition to data on the use of 5-phosphodiesterase inhibitors, intracavernous injections of prostaglandin preparations, vacuum devices, and falloprosthetics, the review presents the results of using low-intensity extracorporeal shock wave therapy (Li-euvt), low-intensity pulsed ultrasound (LIPUS), and autoplasm enriched with platelet growth factors (AOT). Conclusions. All the methods listed in the review have shown good results and are promising measures for penile rehabilitation of patients after radical prostatectomy, but their implementation in clinical practice requires large randomized trials that could confirm their effectiveness and safety.