Rehabilitation der Schwellkörperfunktion nach radikalen uroonkologischen Eingriffen

Corpus cavernosum rehabilitation after radical urooncological procedures

Zusammenfassung

Die Schwellkörperrehabilitation ist integraler Bestandteil moderner, lebensqualitätsorientierter uroonkologischer Therapiekonzepte und damit Aufgabe der fachspezifischen urologischen Rehabilitation. Diese basiert auf 3 therapeutischen Optionen: der Verwendung von PDE-5-Inhibitoren, dem Einsatz der Schwellkörperinjektionstherapie und der Anwendung des Vakuumtherapiesystems. Abhängig von den operationstechnischen Gegebenheiten werden die verschiedenen Verfahren indikationsgerecht eingesetzt und ermöglichen somit ein zeitnahes Wiedererlangen der erektilen Funktion.

Abstract

Corpus cavernosum rehabilitation is an integral part of modern, quality-of-life-oriented urooncological concepts and therefore a basic task of specific urological rehabilitation. Sexual rehabilitation is based on three different therapeutic options: PDE-5 inhibitors, use of corpus cavernosum injection therapy, and use of a therapeutic vacuum device. The indication depends on the status of nerve protection. Close recovery of erectile function is possible.

This is a preview of subscription content, access via your institution.

Abb. 1
Abb. 2
Abb. 3
Abb. 4

Literatur

  1. 1.

    Briganti A, Salonia A, Gallina A et al. (2007) F. Management of erectile dysfunction after radical prostatectomy in 2007. World J Urol 25: 143–148

    PubMed  Article  Google Scholar 

  2. 2.

    Ciancio SJ, Kim ED (2000) Penile fibrotic changes after radical retropubic prostatectomy. BJU Int 85: 101–6

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    Davison BJ, Elliott S, Ekland M et al. (2005) Development and evaluation of a prostate sexual rehabilitation clinic: a pilot project. BJU Int 96: 1360–1364

    PubMed  Article  Google Scholar 

  4. 4.

    Ferrini MG, Davila HH, Kovanecz I et al. (2006) Vardenafil prevents fibrosis and loss of corporal smooth muscle that occurs after bilateral cavernosal nerve resection in the rat. Urology 68: 429–35

    PubMed  Article  Google Scholar 

  5. 5.

    Davison BJ, Alan I, So S (2007) Larry Goldenberg: Quality of life, sexual function and decisional regret at 1 year after surgical treatment for localized prostate cancer. BJU Intern 100: 780–785

    Article  Google Scholar 

  6. 6.

    Klein LT, Miller MI, Buttyan R et al. (1997) Apoptosis in the rat penis after penile denervation. J Urol 158: 626–630

    PubMed  Article  CAS  Google Scholar 

  7. 7.

    Köhler TS, Pedro R, Hendlin K et al. (2007) A pilot study on the early use of the vacuum erection device after radical retropubic prostatectomy. BJU Int 100: 858–862

    PubMed  Article  Google Scholar 

  8. 8.

    Kovanecz I, Rambhatla A, Ferrini M et al. (2007) Long-term continuous sildenafil treatment ameliorates corporal veno-occlusive dysfunction (CVOD) induced by cavernosal nerve resection in rats. Int J Impot Res 20

  9. 9.

    Kovanecz I, Rambhatla A, Ferrini MG et al. (2008) Chronic daily tadalafil prevents the corporal fibrosis and veno-occlusive dysfunction that occurs after cavernosal nerve resection. BJU Int 101(2): 203–210

    PubMed  CAS  Google Scholar 

  10. 10.

    Montorsi F, Nathan HP, McCullough A et al. (2004) Tadalafil in the treatment of erectile dysfunction following bilateral nerve sparing radical retropubic prostatectomy: a randomized, double-blind, placebo controlled trial. J Urol 172: 1036–1041

    PubMed  Article  CAS  Google Scholar 

  11. 11.

    Montorsi F, McCullough A (2005) Efficacy of sildenafil citrate in men with erectile dysfunction following radical prostatectomy: a systematic review of clinical data. J Sex Med 2: 658–667

    PubMed  Article  CAS  Google Scholar 

  12. 12.

    Nandipati KC, Raina R, Agarwal A, Zippe CD (2006) Erectile dysfunction following radical retropubic prostatectomy: epidemiology, pathophysiology and pharmacological management. Drugs Aging 23: 101–117

    PubMed  Article  CAS  Google Scholar 

  13. 13.

    Nehra A, Grantmyre J, Nadel A, Thibonnier M, Brock G (2005) Vardenafil improved patient satisfaction with erectile hardness, orgasmic function and sexual experience in men with erectile dysfunction following nerve sparing radical prostatectomy. J Urol 173: 2067–2071

    PubMed  Article  CAS  Google Scholar 

  14. 14.

    Robert-Koch-Institut (Hrsg) und die Gesellschaft der epidemiologischen Krebsregister in Deutschalnd e.V. (Hrsg) (2008) Krebs in Deutschland 2003–2004. Häufigkeiten und Trends. 6,, überarbeitete Auflage. RKI, Berlin

  15. 15.

    User HM, Hairston JH, Zelner DJ et al. (1983) Penile weight and cell subtype specific changes in a post-radical prostatectomy model of erectile dysfunction. J Urol 169: 1175–1179

    Article  Google Scholar 

  16. 16.

    Walsh PC, Lepor H, Eggleston JC (1983) Radical prostatectomy with preservation of sexual function: anatomical and pathological considerations. Prostate 4: 473–485

    PubMed  Article  CAS  Google Scholar 

  17. 17.

    Zermann DH (2006) Rehabilitationsziele in der Anschlußheilbehandlung (AHB) nach radikaler Prostatektomie. Physik Med 16

  18. 18.

    Zermann DH (2007) Early corpus cavernosus rehabilitation (ECCR) after radical prostatectomy –results and patient’s preference. Europ Urol 6(Suppl): 209

    Google Scholar 

  19. 19.

    Zippe CD, Pahlajani G (2007) Penile rehabilitation following radical prostatectomy: role of early intervention and chronic therapy. Urol Clin North Am 34: 601–618

    PubMed  Article  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Affiliations

Authors

Corresponding author

Correspondence to PD Dr. habil. D.-H. Zermann.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Zermann, DH. Rehabilitation der Schwellkörperfunktion nach radikalen uroonkologischen Eingriffen. Urologe 47, 693–698 (2008). https://doi.org/10.1007/s00120-008-1665-x

Download citation

Schlüsselwörter

  • Prostatakarzinom
  • Prostatektomie
  • Lebensqualität
  • Erektile Dysfunktion
  • Rehabilitation

Keywords

  • Prostate cancer
  • Prostatectomy
  • Quality of life
  • Erectile dysfunction
  • Rehabilitation