�UroToday.com - Prostate cancer is the leading malignancy in American men and causes more than 60,000 deaths annually. Treatment of prostate cancer with either surgery, radiation therapy, cryotherapy or medical treatment is associated with significant life altering morbidity. Both incontinence and erectile dysfunction (ED) are too ofttimes sequelae of these discourse alternatives. ED can be a significant complication and can alter the life of both the prostate cancer patient and his partner. Newer modifications of the radical prostatectomy with nerve scotch techniques are the cornerstone of erection preservation.
Time following radical prostatectomy has been shown to increase erectile social occasion such that more patients have functional erections at 3 age than 1 year after surgery. With the coming of PDE 5 inhibitors, many hands can have improved working erections and return to active coitus. Prevention of ED is also an important direction technique. Evidence is gathering that prophylaxis with regular vasoactive injectant or daily PDE 5 agents may be an integral component part of preservation of principal cavernosum smooth muscle function. Combination medical therapy and surgical penial prosthesis implantation are likewise options for patients failing oral PDE 5 inhibitors.
Lower urinary tract symptoms (LUTS) ar an eld independent risk of exposure factor for ED as demonstrated by large epidemiologic studies such as the MSAM-7 study. Etiology may be mediated via alpha adrenergic over activity. The large concentrations of PDE5 receptors in prostate, bladder and urethra suggest that PDE5 inhibitors may be a treatment alternative for the ED LUTS combination.
Presented by: Culley C. Carson, MD, at the Masters in Urology Meeting - July 31, 2008 - August 2, 2008, Elbow Beach, Bermuda
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