Treatment in Germany - see top hospital ratings and lists of best specialists, up-to-date information prices adresses and contacts
23.11.2018 14:34:48
After nerve-sparing radical prostatectomy, early recovery contributes to the successful treatment of erectile dysfunction, and therefore to possible erectile function recovery in a short time.
When men are forced to undergo radical prostatectomy (RP) because of prostate carcinoma, many of them fear incontinence and impotence as a consequence of the surgery. There are other synonyms for impotence, such as erectile disorder and erectile dysfunction. Impotence means not only an unsatisfactory erection during sexual intercourse, but also sex impotence. In most cases, patients with prostate cancer can no longer have children, so erectile dysfunction (ED) is in the foreground. From 14% to 90% of patients suffer from it after the surgery. Among other things, it depends on the age, the degree of nerve preservation, the time frame of the examinations or rehabilitation measures.
During the nerve-sparing operation, erectile dysfunction (ED) can be caused by the fact that the nerve functions get damaged due to pressure or tension of the neurovascular bundles, i.e. due to circulatory disorders. It may slow down the recovery of potency. Also during the surgery, the corpus cavernosum muscles in the penis can be damaged.
It is all the more important to start carrying out supportive measures that are necessary after the operation as soon as possible in order to improve the speed of spontaneous erection. They may include taking medications, such as PDE-5 inhibitors (orally or as intracavernous injections) or Prostaglandin E1 (Alprostadil), or using a vacuum erection device.
The study conducted by the Urology Expert Centre of the Hartenstein clinic in Bad Wildung wanted to find out what early recovery, that is timely rehabilitation after nerve-sparing RPE for erectile function, could be. Thereto, 4,982 patients with localized prostate carcinoma after RPE were treated as part of early rehabilitation from January 2014 to December 2015. Additionally, the erectile status, the preservation of the nerves, the patients’ desire for recovery, as well as the effectiveness of taking PDE-5 inhibitors were recorded before and after the surgery. The data on erectile status were based on the patients’ self-esteem. In addition, they participated in an intensive psychotherapeutic ED training developed at the clinic to improve erectile function.
The results showed that in patients who underwent unilateral or bilateral nerve-sparing surgery, erection was 81.9% before the operation, which was sufficient for sexual intercourse. Of these, 40% (bilateral nerve-sparing surgery) and 33.2% (unilateral) expressed a wish to restore erectile function during rehabilitation after treatment.
When taking PDE-5 inhibitors, 40% of patients after nerve-sparing surgery, by the end of the rehabilitation period, i.e. 5-6 weeks later, had reported a noticeably better swelling of the penis up to an erection sufficient for sexual intercourse. This fact shows very good early functional results of nerve-sparing RPE, as well as the rehabilitation of erectile function. Therefore, in order to improve the quality of life, relevant patients should contact the rehabilitation centre.
