Prostate Cancer and Erectile Disfunction

A special issue of Uro (ISSN 2673-4397).

Deadline for manuscript submissions: 15 May 2024 | Viewed by 10567

Special Issue Editor

Department of Urology, Vito Fazzi Hospital, Lecce, Italy
Interests: urothelial cancer; translational research; minimal invasive surgery; robotic surgery

Special Issue Information

Dear Colleagues,

Prostate cancer (PCa) is the second most common cancer in males, and it represents the first cause of cancer death for cancer in this population. In the last few years, the incidence of PCa in young men has been increasing as a result of several factors, and this has an important impact on sexual function and quality of life. It is known that PCa treatments such as radical prostatectomy, radiotherapy, and castration therapy impact sexual function with different action mechanisms. However, the psychological distress related to cancer diagnosis, and specifically prostate cancer diagnosis, might add a particular burden on erectile function in a subset of patients that may already have some initial erectile difficulty due to the aging further compromising quality of life. Here I would like to investigate with mini-reviews the state of the art of the following related topics:

  • Prostate cancer diagnosis and psychological distress: impact on erectile function;
  • Radical prostatectomy and minimally invasive prostate cancer treatment: impact on erectile function;
  • Radiotherapy and hormonal treatment: impact on erectile function;
  • Rehabilitation after prostate cancer treatment: which is the right program?
  • New sexual rehabilitation tools after prostate cancer treatments: an overview.

Dr. Alessandro Tafuri
Guest Editor

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Keywords

  • prostate cancer
  • prostate cancer treatment
  • radiotherapy
  • castration therapy
  • radical prostatectomy
  • erectile disfunction

Published Papers (4 papers)

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Review

13 pages, 610 KiB  
Review
Current Knowledge on Radiation-Therapy-Induced Erectile Dysfunction in Prostate-Cancer Patients: A Narrative Review
by Connie Labate, Andrea Panunzio, Francesco De Carlo, Federico Zacheo, Sara De Matteis, Maria Cristina Barba, Umberto Carbonara, Floriana Luigina Rizzo, Silvana Leo, Saverio Forte, Pasquale Ditonno, Alessandro Tafuri and Vincenzo Pagliarulo
Uro 2023, 3(2), 104-116; https://doi.org/10.3390/uro3020013 - 01 Apr 2023
Viewed by 2945
Abstract
Prostate cancer is the most frequently diagnosed cancer in men in the United States. Among the different available treatment options, radiation therapy is recommended for localized or even advanced disease. Erectile dysfunction (ED) often occurs after radiation therapy due to neurological, vascular, and [...] Read more.
Prostate cancer is the most frequently diagnosed cancer in men in the United States. Among the different available treatment options, radiation therapy is recommended for localized or even advanced disease. Erectile dysfunction (ED) often occurs after radiation therapy due to neurological, vascular, and endocrine mechanisms resulting in arterial tone alteration, pudendal-nerve neuropraxia, and lastly fibrosis. Considering the influence of quality of life on patients’ treatment choice, radiation-therapy-induced ED prevention and treatment are major issues. In this narrative review, we briefly summarize and discuss the current state of the art on radiation-therapy-induced ED in PCa patients in terms of pathophysiology and available treatment options. Full article
(This article belongs to the Special Issue Prostate Cancer and Erectile Disfunction)
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13 pages, 293 KiB  
Review
Penile Rehabilitation after Prostate Cancer Treatment: Which Is the Right Program?
by Roberto Castellucci, Piergustavo De Francesco, Antonio De Palma, Davide Ciavarella, Simone Ferretti, Michele Marchioni and Luigi Schips
Uro 2023, 3(1), 61-73; https://doi.org/10.3390/uro3010009 - 23 Feb 2023
Cited by 1 | Viewed by 3028
Abstract
The management of sexual complications after treatment of localized prostate cancer, such as erectile dysfunction, changes in the length of the penis, pain during sexual intercourse, and lack of orgasm, is still an unsolved problem with an important impact on patients’ quality of [...] Read more.
The management of sexual complications after treatment of localized prostate cancer, such as erectile dysfunction, changes in the length of the penis, pain during sexual intercourse, and lack of orgasm, is still an unsolved problem with an important impact on patients’ quality of life. In this review, we summarize the current scientific literature about the rehabilitation of erectile dysfunction after prostate cancer treatment. The therapy for penile rehabilitation includes different types of treatments: the combination of phosphodiesterase type 5 inhibitors (PDE5-I) and the vacuum erectile device (VED) are considered first-line treatment options. When therapy begins, the duration of treatment, the dosage and the drug used all play very important roles in the treatment outcome. Intracavernous injection (ICI) therapy represents the second-line option for patients ineligible for PDE5-I therapy. Technological development has led to the emergence of devices for the stimulation of the penis without the use of drugs, such as penile vibratory stimulation (PVS) for stimulation of ejaculation in spinal cord injury and low-intensity extracorporeal shockwave therapy (LIESWT). The rapid diffusion of the latter, thanks to its easy use, attains good results without side effects. The panorama of penile rehabilitation after PC treatments is vast and many studies are needed, especially on new technologies, to find the best therapeutic regimen possible, personalized to the patient’s characteristics and the type of treatment for PC. Full article
(This article belongs to the Special Issue Prostate Cancer and Erectile Disfunction)
7 pages, 1094 KiB  
Review
Relationship between Androgen Deprivation Therapy and Abdominal Adipose Tissue
by Federico Greco, Alessandro Tafuri, Andrea Panunzio, Bruno Beomonte Zobel and Carlo Augusto Mallio
Uro 2022, 2(4), 270-276; https://doi.org/10.3390/uro2040030 - 02 Dec 2022
Viewed by 1087
Abstract
The role of androgens in body composition is well known. Androgen deprivation therapy (ADT) has shown beneficial effects in the treatment of advanced prostate cancer (PCa). Given that androgens are important for the homeostasis of different organs, the effects of ADT can affect [...] Read more.
The role of androgens in body composition is well known. Androgen deprivation therapy (ADT) has shown beneficial effects in the treatment of advanced prostate cancer (PCa). Given that androgens are important for the homeostasis of different organs, the effects of ADT can affect body composition and therefore adipose tissue. Computed tomography (CT) and magnetic resonance imaging (MRI) are non-invasive methods that allow for quantification of the different fat compartments. In this review we describe the effects of ADT on abdominal adipose tissue in PCa patients. Full article
(This article belongs to the Special Issue Prostate Cancer and Erectile Disfunction)
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9 pages, 240 KiB  
Review
Focal Therapy for Prostate Cancer: The Impact on Sexual Function
by Lorenzo Storino Ramacciotti, Donya S. Jadvar, Maria Sarah L. Lenon, Giovanni E. Cacciamani, Andre Luis Abreu and Masatomo Kaneko
Uro 2022, 2(4), 204-212; https://doi.org/10.3390/uro2040025 - 09 Oct 2022
Cited by 1 | Viewed by 2527
Abstract
Focal therapy (FT) has emerged as a potential treatment for localized prostate cancer (PCa) with encouraging functional outcomes. According to the compelling evidence based on meta-analyses and recent trials, erectile function (EF) is mostly retained at 6 and 12 months after FT when [...] Read more.
Focal therapy (FT) has emerged as a potential treatment for localized prostate cancer (PCa) with encouraging functional outcomes. According to the compelling evidence based on meta-analyses and recent trials, erectile function (EF) is mostly retained at 6 and 12 months after FT when compared to baseline. These findings are consistent across different energy sources reported to date. However, overall, quality of life, including impotence, was not the endpoint for most studies. Additionally, impotency has not been consistently reported in most of the recent literature. Furthermore, confounding factors such as baseline potency and usage of phosphodiesterase 5 inhibitors (PDE5-I) were also frequently undisclosed. Long-term functional outcomes are awaited. To fully comprehend how FT affects EF, more extensive long-term randomized clinical trials using EF as a primary outcome are needed. Full article
(This article belongs to the Special Issue Prostate Cancer and Erectile Disfunction)
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