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Erectile Dysfunction

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Prostate Cancer: A Comprehensive Perspective

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Abstract

Erectile dysfunction (ED) is defined as the persistent inability to attain and maintain an erection with sufficient rigidity to perform satisfactory penetrative sexual activity [1]. ED is strongly associated with age and cardiovascular risk factors. Aside from these factors, ED is a frequent long-term complication of the treatment of prostate cancer (PCa). Various treatment options for PCa currently are available, including radical prostatectomy (RP), external beam radiation (EBRT), brachytherapy (BT), and androgen deprivation therapy (ADT); for most urologists, RP is the preferred treatment option for the majority of men with organ-confined disease [2]. The maintenance of a satisfactory quality of life is the principle concern in almost half of the men who elect treatment for localized PCa [3]. Furthermore, sexual dysfunction has been reported to be an independent determinant of a poorer general health-related quality of life at 2 years after primary treatment for PCa [4]. The development of ED over time is not uniform among different treatment options (Fig. 81.1). While following (nerve-sparing) RP, almost every patient develops ED shortly after the surgery; a recovery of erectile function is seen with nerve regeneration until a plateau in erectile function is reached about 18–24 months after surgery. In non-nerve-sparing RP, the same effect is seen, but recovery is only seen in few patients. Following radiotherapy, a gradual decline in potency is seen following treatment, which continues over a long period of time (reported up till 5 years). This effect may explain why in short-term outcome studies, radiotherapy may be perceived as less harmful to erectile function compared to surgical treatment. The “PCa outcomes study,” however, showed similar low potency rates in a large cohort of patients treated with RP compared to those treated with EBRT 5 years after initiation of treatment [5]. The difference in evolution of ED following various treatments was also reflected in the fact that health-related quality of life remains stable between 2.6 and 6.2 years after RP, while, in patients treated with BT or EBRT, this continued to decline in the studied interval [6]. Following ADT, there is a rather quick drop in potency which generally persists during the treatment period which is also reflected in a decrease in quality of life during the first year after initiation of ADT [7].

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References

  1. NIH Consensus Conference. Impotence. NIH consensus development panel on impotence. JAMA. 1993;270(1):83–90.

    Article  Google Scholar 

  2. Kendirci M, Bejma J, Hellstrom WJG. Radical prostatectomy and other pelvic surgeries: effects on erectile function. In: Mulcahy J, editor. Male sexual function: a guide to clinical practice. 2nd ed. Towana: Humana Press; 2006. p. 135–54.

    Chapter  Google Scholar 

  3. Crawford ED, Bennett CL, Stone NN, et al. Comparison of perspectives on prostate cancer: analyses of survey data. Urology. 1997;50(3):366–72.

    Article  PubMed  CAS  Google Scholar 

  4. Penson DF, Feng Z, Kuniyuki A, et al. General quality of life 2 years following treatment for prostate cancer: what influences outcomes? Results from the prostate cancer outcomes study. J Clin Oncol. 2003;21(6):1147–54.

    Article  PubMed  Google Scholar 

  5. Potosky AL, Davis WW, Hoffman RM, et al. Five-year outcomes after prostatectomy or radiotherapy for prostate cancer: the prostate cancer outcomes study. J Natl Cancer Inst. 2004;96(18):1358–67.

    Article  PubMed  Google Scholar 

  6. Miller DC, Sanda MG, Dunn RL, et al. Long-term outcomes among localized prostate cancer survivors: health-related quality-of-life changes after radical prostatectomy, external radiation, and brachytherapy. J Clin Oncol. 2005;23(12):2772–80.

    Article  PubMed  Google Scholar 

  7. Potosky AL, Reeve BB, Clegg LX, et al. Quality of life following localized prostate cancer treated initially with androgen deprivation therapy or no therapy. J Natl Cancer Inst. 2002;94(6):430–7.

    Article  PubMed  Google Scholar 

  8. Albersen M, Joniau S, Van Poppel H. The use of iief-5 for reporting erectile dysfunction following nerve-sparing radical retropubic prostatectomy. Open Prostate Cancer J. 2009;2:1–9.

    Article  Google Scholar 

  9. Coelho RF, Rocco B, Patel MB, et al. Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a critical review of outcomes reported by high-volume centers. J Endourol. 2010;24(12):2003–15.

    Article  PubMed  Google Scholar 

  10. Ficarra V, Novara G, Artibani W, et al. Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a systematic review and cumulative analysis of comparative studies. Eur Urol. 2009;55(5):1037–63.

    Article  PubMed  Google Scholar 

  11. Turner SL, Adams K, Bull CA, et al. Sexual dysfunction after radical radiation therapy for prostate cancer: a prospective evaluation. Urology. 1999;54(1):124–9.

    Article  PubMed  CAS  Google Scholar 

  12. van der Wielen GJ, van Putten WL, Incrocci L. Sexual function after three-dimensional conformal radiotherapy for prostate cancer: results from a dose-escalation trial. Int J Radiat Oncol Biol Phys. 2007;68(2):479–84.

    Article  PubMed  Google Scholar 

  13. Zelefsky MJ, Cowen D, Fuks Z, et al. Long term tolerance of high dose three-dimensional conformal radiotherapy in patients with localized prostate carcinoma. Cancer. 1999;85(11):2460–8.

    Article  PubMed  CAS  Google Scholar 

  14. Merrick GS, Butler WM, Wallner KE, et al. Erectile function after prostate brachytherapy. Int J Radiat Oncol Biol Phys. 2005;62(2):437–47.

    Article  PubMed  Google Scholar 

  15. Potters L, Torre T, Fearn PA, et al. Potency after permanent prostate brachytherapy for localized prostate cancer. Int J Radiat Oncol Biol Phys. 2001;50(5):1235–42.

    Article  PubMed  CAS  Google Scholar 

  16. Stone NN, Stock RG. Long-term urinary, sexual, and rectal morbidity in patients treated with iodine-125 prostate brachytherapy followed up for a minimum of 5 years. Urology. 2007;69(2):338–42.

    Article  PubMed  Google Scholar 

  17. Lue TF. Erectile dysfunction. N Engl J Med. 2000;342(24):1802–13.

    Article  PubMed  CAS  Google Scholar 

  18. Albersen M, Shindel AW, Mwamukonda KB, et al. The future is today: emerging drugs for the treatment of erectile dysfunction. Expert Opin Emerg Drugs. 2010;15(3):467–80.

    Article  PubMed  CAS  Google Scholar 

  19. Walsh PC, Donker PJ. Impotence following radical prostatectomy: insight into etiology and prevention. J Urol. 1982;128(3):492–7.

    PubMed  CAS  Google Scholar 

  20. Awad A, Alsaid B, Bessede T, et al. Evolution in the concept of erection anatomy. Surg Radiol Anat. 2011;33:301–12.

    Article  PubMed  Google Scholar 

  21. Albersen M, Fandel TM, Zhang H, et al. Pentoxifylline promotes recovery of erectile function in a rat model of postprostatectomy erectile dysfunction. Eur Urol. 2011;59:286–96.

    Article  PubMed  CAS  Google Scholar 

  22. Taskinen HS, Ruohonen S, Jagodic M, et al. Distinct expression of TGF-beta1 mRNA in the endo- and epineurium after nerve injury. J Neurotrauma. 2004;21:969–75.

    Article  PubMed  CAS  Google Scholar 

  23. Albersen M, Joniau S, Claes H, et al. Preclinical evidence for the benefits of penile rehabilitation therapy following nerve-sparing radical prostatectomy. Adv Urol. 2008;2008:594868.

    Google Scholar 

  24. Azadzoi KM, Vlachiotis J, Pontari M, et al. Hemodynamics of penile erection: III. Measurement of deep intracavernosal and subtunical blood flow and oxygen tension. J Urol. 1995;153(2):521–6.

    Article  PubMed  CAS  Google Scholar 

  25. Bannowsky A, Schulze H, van der Horst C, et al. Nocturnal tumescence: a parameter for postoperative erectile integrity after nerve sparing radical prostatectomy. J Urol. 2006;175(6):2214–7.

    Article  PubMed  Google Scholar 

  26. Kim N, Azadzoi KM, Goldstein I, et al. A nitric oxide-like factor mediates nonadrenergic-noncholinergic neurogenic relaxation of penile corpus cavernosum smooth muscle. J Clin Invest. 1991;88(1):112–8.

    Article  PubMed  CAS  Google Scholar 

  27. Vignozzi L, Filippi S, Morelli A, et al. Effect of chronic tadalafil administration on penile hypoxia induced by cavernous neurotomy in the rat. J Sex Med. 2006;3(3):419–31.

    Article  PubMed  CAS  Google Scholar 

  28. Vignozzi L, Morelli A, Filippi S, et al. Effect of sildenafil administration on penile hypoxia induced by cavernous neurotomy in the rat. Int J Impot Res. 2008;20(1):60–7.

    Article  PubMed  CAS  Google Scholar 

  29. Leungwattanakij S, Bivalacqua TJ, Usta MF, et al. Cavernous neurotomy causes hypoxia and fibrosis in rat corpus cavernosum. J Androl. 2003;24(2):239–45.

    PubMed  Google Scholar 

  30. Shindel AW, Lin G, Ning H, et al. Pentoxifylline attenuates transforming growth factor-β1-stimulated collagen deposition and elastogenesis in human tunica albuginea-derived fibroblasts part 1: impact on extracellular matrix. J Sex Med. 2010;7(6):2077–85.

    Article  PubMed  CAS  Google Scholar 

  31. Moreland RB. Is there a role of hypoxemia in penile fibrosis: a viewpoint presented to the Society for the Study of Impotence. Int J Impot Res. 1998;10(2):113–20.

    Article  PubMed  CAS  Google Scholar 

  32. Albersen M, Fandel TM, Lin G, et al. Injections of adipose tissue-derived stem cells and stem cell lysate improve recovery of erectile function in a rat model of cavernous nerve injury. J Sex Med. 2010;7(10):3331–40.

    Article  PubMed  Google Scholar 

  33. Klein LT, Miller MI, Buttyan R, et al. Apoptosis in the rat penis after penile denervation. J Urol. 1997;158(2):626–30.

    Article  PubMed  CAS  Google Scholar 

  34. User HM, Hairston JH, Zelner DJ, et al. Penile weight and cell subtype specific changes in a post-radical prostatectomy model of erectile dysfunction. J Urol. 2003;169(3):1175–9.

    Article  PubMed  Google Scholar 

  35. Podlasek CA. Sonic hedgehog, apoptosis, and the penis. J Sex Med. 2009;6 Suppl 3:334–9.

    Article  PubMed  Google Scholar 

  36. Dean RC, Lue TF. Physiology of penile erection and pathophysiology of erectile dysfunction. Urol Clin North Am. 2005;32(4):379–95.

    Article  PubMed  Google Scholar 

  37. van der Wielen GJ, Mulhall JP, Incrocci L. Erectile dysfunction after radiotherapy for prostate cancer and radiation dose to the penile structures: a critical review. Radiother Oncol. 2007;84(2):107–13.

    Article  PubMed  Google Scholar 

  38. Mulhall J, Ahmed A, Parker M, et al. The hemodynamics of erectile dysfunction following external beam radiation for prostate cancer. J Sex Med. 2005;2:432–7.

    Article  PubMed  Google Scholar 

  39. Carrier S, Hricak H, Lee SS, et al. Radiation-induced decrease in nitric oxide synthase–containing nerves in the rat penis. Radiology. 1995;195(1):95–9.

    PubMed  CAS  Google Scholar 

  40. Sener G, Atasoy BM, Ersoy Y, et al. Melatonin protects against ionizing radiation-induced oxidative damage in corpus cavernosum and urinary bladder in rats. J Pineal Res. 2004;37(4):241–6.

    Article  PubMed  CAS  Google Scholar 

  41. Johnke RM, Edwards JM, Evans MJ, et al. Circulating cytokine levels in prostate cancer patients undergoing radiation therapy: influence of neoadjuvant total androgen suppression. In Vivo. 2009;23(5):827–33.

    PubMed  CAS  Google Scholar 

  42. Jones RW, Rees RW, Minhas S, et al. Oxygen free radicals and the penis. Expert Opin Pharmacother. 2002;3(7):889–97.

    Article  PubMed  CAS  Google Scholar 

  43. van der Wielen GJ, Vermeij M, de Jong BW, et al. Changes in the penile arteries of the rat after fractionated irradiation of the prostate: a pilot study. J Sex Med. 2009;6(7):1908–13.

    Article  PubMed  Google Scholar 

  44. Merlin SL, Brock GB, Begin LR, et al. New insights into the role of endothelin-1 in radiation-associated impotence. Int J Impot Res. 2001;13(2):104–9.

    Article  PubMed  CAS  Google Scholar 

  45. Traish AM, Guay AT. Are androgens critical for penile erections in humans? Examining the clinical and preclinical evidence. J Sex Med. 2006;3(3):382–404, discussion 404–7.

    Article  PubMed  CAS  Google Scholar 

  46. Peters CA, Walsh PC. The effect of nafarelin acetate, a luteinizing-hormone-releasing hormone agonist, on benign prostatic hyperplasia. N Engl J Med. 1987;317(10):599–604. Erratum in: N Engl J Med. 1988;318(9):580.

    Article  PubMed  CAS  Google Scholar 

  47. Marumo K, Baba S, Murai M. Erectile function and nocturnal penile tumescence in patients with prostate cancer undergoing luteinizing hormone-releasing hormone agonist therapy. Int J Urol. 1999;6(1):19–23.

    Article  PubMed  CAS  Google Scholar 

  48. Traish AM, Kim N. Weapons of penile smooth muscle destruction: androgen deficiency promotes accumulation of adipocytes in the corpus cavernosum. Aging Male. 2005;8(3–4):141–6.

    Article  PubMed  CAS  Google Scholar 

  49. Baba K, Yajima M, Carrier S, et al. Effect of testosterone on the number of NADPH diaphorase-stained nerve fibers in the rat corpus cavernosum and dorsal nerve. Urology. 2000;56(3):533–8.

    Article  PubMed  CAS  Google Scholar 

  50. Morelli A, Filippi S, Mancina R, et al. Androgens regulate phosphodiesterase type 5 expression and functional activity in corpora cavernosa. Endocrinology. 2004;145(5):2253–63.

    Article  PubMed  CAS  Google Scholar 

  51. Yang R, Huang YC, Lin G, et al. Lack of direct androgen regulation of PDE5 expression. Biochem Biophys Res Commun. 2009;380(4):758–62.

    Article  PubMed  CAS  Google Scholar 

  52. Walsh PC. The discovery of the cavernous nerves and development of nerve sparing radical retropubic prostatectomy. J Urol. 2007;177(5):1632–5.

    Article  PubMed  Google Scholar 

  53. Walsh PC. Nerve grafts are rarely necessary and are unlikely to improve sexual function in men undergoing anatomic radical prostatectomy. Urology. 2001;57(6):1020–4.

    Article  PubMed  CAS  Google Scholar 

  54. White WM, Kim ED. Interposition nerve grafting during radical prostatectomy: cumulative review and critical appraisal of literature. Urology. 2009;74(2):245–50.

    Article  PubMed  Google Scholar 

  55. Ball RA, Richie JP, Vickers Jr MA. Microsurgical nerve graft repair of the ablated cavernosal nerves in the rat. J Surg Res. 1992;53(3):280–6.

    Article  PubMed  CAS  Google Scholar 

  56. Davis JW, Chang DW, Chevray P, et al. Randomized phase II trial evaluation of erectile function after attempted unilateral cavernous nerve-sparing retropubic radical prostatectomy with versus without unilateral sural nerve grafting for clinically localized prostate cancer. Eur Urol. 2009;55(5):1135–43.

    Article  PubMed  Google Scholar 

  57. Namiki S, Ishidoya S, Tochigi T, et al. Health-related quality of life after intensity modulated radiation therapy for localized prostate cancer: comparison with conventional and conformal radiotherapy. Jpn J Clin Oncol. 2006;36(4):224–30.

    Article  PubMed  Google Scholar 

  58. McLaughlin PW, Narayana V, Meirovitz A, et al. Vessel-sparing prostate radiotherapy: dose limitation to critical erectile vascular structures (internal pudendal artery and corpus cavernosum) defined by MRI. Int J Radiat Oncol Biol Phys. 2005;61(1):20–31.

    Article  PubMed  Google Scholar 

  59. Roach 3rd M, Nam J, Gagliardi G, et al. Radiation dose-volume effects and the penile bulb. Int J Radiat Oncol Biol Phys. 2010;76(3 Suppl):S130–4.

    Article  PubMed  Google Scholar 

  60. Ritter MA, Schulz CA, Hendee E. Erectile dysfunction and brachytherapy-related doses to the neurovascular bundles (abstr). Int J Radiat Oncol Biol Phys. 2000;48:250.

    Google Scholar 

  61. Merrick GS, Butler WM, Galbreath RW, et al. Erectile function after permanent prostate brachytherapy. Int J Radiat Oncol Biol Phys. 2002;52(4):893–902.

    Article  PubMed  Google Scholar 

  62. Berk A, Mulhall J, Nelson C. Defining gold standard measures for erectile dysfunction in prostate cancer patients. J Urol. 2010;183(4 Suppl):e471.

    Article  Google Scholar 

  63. Hatzimouratidis K, Amar E, Eardley I, European Association of Urology, et al. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol. 2010;57(5):804–14.

    Article  PubMed  Google Scholar 

  64. Zippe CD, Jhaveri FM, Klein EA, et al. Role of Viagra after radical prostatectomy. Urology. 2000;55(2):241–5.

    Article  PubMed  CAS  Google Scholar 

  65. Zagaja GP, Mhoon DA, Aikens JE, et al. Sildenafil in the treatment of erectile dysfunction after radical prostatectomy. Urology. 2000;56(4):631–4.

    Article  PubMed  CAS  Google Scholar 

  66. Zelefsky MJ, McKee AB, Lee H, et al. Efficacy of oral sildenafil in patients with erectile dysfunction after radiotherapy for carcinoma of the prostate. Urology. 1999;53(4):775–8.

    Article  PubMed  CAS  Google Scholar 

  67. Ohebshalom M, Parker M, Guhring P, et al. The efficacy of sildenafil citrate following radiation therapy for prostate cancer: temporal considerations. J Urol. 2005;174(1):258–62.

    Article  PubMed  CAS  Google Scholar 

  68. DiBlasio CJ, Malcolm JB, Derweesh IH, et al. Patterns of sexual and erectile dysfunction and response to treatment in patients receiving androgen deprivation therapy for prostate cancer. BJU Int. 2008;102(1):39–43.

    Article  PubMed  Google Scholar 

  69. Porst H, Adaikan G. Self-injection, trans-urethral and topical therapy in erectile dysfunction. In: Porst H, Buvat J, editors. The standards committee of the international society for sexual medicine. Malden: Blackwell Publishing; 2006. p. 94–108.

    Chapter  Google Scholar 

  70. Raina R, Lakin MM, Thukral M, et al. Long-term efficacy and compliance of intracorporeal (IC) injection for erectile dysfunction following radical prostatectomy: SHIM (IIEF-5) analysis. Int J Impot Res. 2003;15(5):318–22.

    Article  PubMed  CAS  Google Scholar 

  71. Baniel J, Israilov S, Segenreich E, et al. Comparative evaluation of treatments for erectile dysfunction in patients with prostate cancer after radical retropubic prostatectomy. BJU Int. 2001;88(1):58–62.

    Article  PubMed  CAS  Google Scholar 

  72. Pierce LJ, Whittington R, Hanno PM, et al. Pharmacologic erection with intracavernosal injection for men with sexual dysfunction following irradiation: a preliminary report. Int J Radiat Oncol Biol Phys. 1991;21(5):1311–4.

    Article  PubMed  CAS  Google Scholar 

  73. Costabile RA, Spevak M, Fishman IJ, et al. Efficacy and safety of transurethral alprostadil in patients with erectile dysfunction following radical prostatectomy. J Urol. 1998;160(4):1325–8.

    Article  PubMed  CAS  Google Scholar 

  74. Lewis RW, Witherington R. External vacuum therapy for erectile dysfunction: use and results. World J Urol. 1997;15(1):78–82.

    Article  PubMed  CAS  Google Scholar 

  75. Hellstrom WJ, Montague DK, Moncada I, et al. Implants, mechanical devices, and vascular surgery for erectile dysfunction. J Sex Med. 2010;7(1 Pt 2):501–23.

    Article  PubMed  Google Scholar 

  76. Sadeghi-Nejad H. Penile prosthesis surgery: a review of prosthetic devices and associated complications. J Sex Med. 2007;4(2):296–309. Review. Erratum in: J Sex Med. 2007;4(5):1520.

    Article  PubMed  Google Scholar 

  77. Khoudary KP, DeWolf WC, Bruning 3rd CO, et al. Immediate sexual rehabilitation by simultaneous placement of penile prosthesis in patients undergoing radical prostatectomy: initial results in 50 patients. Urology. 1997;50(3):395–9.

    Article  PubMed  CAS  Google Scholar 

  78. Ramsawh HJ, Morgentaler A, Covino N, et al. Quality of life following simultaneous placement of penile prosthesis with radical prostatectomy. J Urol. 2005;174(4 Pt 1):1395–8.

    Article  PubMed  Google Scholar 

  79. Lane BR, Montague DK. Non-pharmacological erectile dysfunction treatment following prostate cancer therapy. In: Mulhall JP, editor. Sexual function in the prostate cancer patient. Towana: Humana Press; 2009. p. 209–331.

    Chapter  Google Scholar 

  80. Dubocq FM, Bianco Jr FJ, Maralani SJ, et al. Outcome analysis of penile implant surgery after external beam radiation for prostate cancer. J Urol. 1997;158(5):1787–90.

    Article  PubMed  CAS  Google Scholar 

  81. Teloken P, Mesquita G, Montorsi F, et al. Post-radical prostatectomy pharmacological penile rehabilitation: practice patterns among the international society for sexual medicine practitioners. J Sex Med. 2009;6(7):2032–8.

    Article  PubMed  Google Scholar 

  82. Garcia FJ, Brock G. Current state of penile rehabilitation after radical prostatectomy. Curr Opin Urol. 2010;20(3):234–40.

    Article  PubMed  Google Scholar 

  83. Montorsi F, Guazzoni G, Strambi LF, et al. Recovery of spontaneous erectile function after nerve-sparing radical retropubic prostatectomy with and without early intracavernous injections of alprostadil: results of a prospective, randomized trial. J Urol. 1997;158(4):1408–10.

    Article  PubMed  CAS  Google Scholar 

  84. Kim ED. Local therapies to heal the penis: fact or fiction? J Androl. 2009;30(4):384–90.

    Article  PubMed  CAS  Google Scholar 

  85. Gontero P, Fontana F, Bagnasacco A, et al. Is there an optimal time for intracavernous prostaglandin E1 rehabilitation following nonnerve sparing radical prostatectomy? Results from a hemodynamic prospective study. J Urol. 2003;169(6):2166–9.

    Article  PubMed  Google Scholar 

  86. Mulhall J, Land S, Parker M, et al. The use of an erectogenic pharmacotherapy regimen following radical prostatectomy improves recovery of spontaneous erectile function. J Sex Med. 2005;2(4):532–40.

    Article  PubMed  CAS  Google Scholar 

  87. Raina R, Pahlajani G, Agarwal A, et al. The early use of transurethral alprostadil after radical prostatectomy potentially facilitates an earlier return of erectile function and successful sexual activity. BJU Int. 2007;100(6):1317–21.

    Article  PubMed  Google Scholar 

  88. McCullough AR, Hellstrom WG, Wang R, et al. Recovery of erectile function after nerve sparing radical prostatectomy and penile rehabilitation with nightly intraurethral alprostadil versus sildenafil citrate. J Urol. 2010;183(6):2451–6.

    Article  PubMed  CAS  Google Scholar 

  89. Padma-Nathan H, McCullough AR, Levine LA, et al. Randomized, double-blind, placebo-controlled study of postoperative nightly sildenafil citrate for the prevention of erectile dysfunction after bilateral nerve-sparing radical prostatectomy. Int J Impot Res. 2008;20(5):479–86.

    Article  PubMed  CAS  Google Scholar 

  90. McCullough AR, Levine LA, Padma-Nathan H. Return of nocturnal erections and erectile function after bilateral nerve-sparing radical prostatectomy in men treated nightly with sildenafil citrate: subanalysis of a longitudinal randomized double-blind placebo-controlled trial. J Sex Med. 2008;5(2):476–84.

    Article  PubMed  CAS  Google Scholar 

  91. Montorsi F, Brock G, Lee J, et al. Effect of nightly versus on-demand vardenafil on recovery of erectile function in men following bilateral nerve-sparing radical prostatectomy. Eur Urol. 2008;54(4):924–31.

    Article  PubMed  CAS  Google Scholar 

  92. Bosshardt RJ, Farwerk R, Sikora R, et al. Objective measurement of the effectiveness, therapeutic success and dynamic mechanisms of the vacuum device. Br J Urol. 1995;75(6):786–91.

    Article  PubMed  CAS  Google Scholar 

  93. Raina R, Agarwal A, Ausmundson S, et al. Early use of vacuum constriction device following radical prostatectomy facilitates early sexual activity and potentially earlier return of erectile function. Int J Impot Res. 2006;18(1):77–81.

    Article  PubMed  CAS  Google Scholar 

  94. Köhler TS, Pedro R, Hendlin K, et al. A pilot study on the early use of the vacuum erection device after radical retropubic prostatectomy. BJU Int. 2007;100(4):858–62.

    Article  PubMed  Google Scholar 

  95. Incrocci L, Koper PC, Hop WC, et al. Sildenafil citrate (Viagra) and erectile dysfunction following external beam radiotherapy for prostate cancer: a randomized, double-blind, placebo-controlled, cross-over study. Int J Radiat Oncol Biol Phys. 2001;51(5):1190–5.

    Article  PubMed  CAS  Google Scholar 

  96. Incrocci L, Slagter C, Slob AK, et al. A randomized, double-blind, placebo-controlled, cross-over study to assess the efficacy of tadalafil (Cialis) in the treatment of erectile dysfunction following three-dimensional conformal external-beam radiotherapy for prostatic carcinoma. Int J Radiat Oncol Biol Phys. 2006;66(2):439–44.

    Article  PubMed  CAS  Google Scholar 

  97. Incrocci L, Slob AK, Hop WC. Tadalafil (Cialis) and erectile dysfunction after radiotherapy for prostate cancer: an open-label extension of a blinded trial. Urology. 2007;70(6):1190–3.

    Article  PubMed  Google Scholar 

  98. Peltier A, van Velthoven R, Roumeguère T. Current management of erectile dysfunction after cancer treatment. Curr Opin Oncol. 2009;21(4):303–9.

    Article  PubMed  CAS  Google Scholar 

  99. Sezen SF, Hoke A, Burnett AL, et al. Immunophilin ligand FK506 is neuroprotective for penile innervation. Nat Med. 2001;7(10):1073–4.

    Article  PubMed  CAS  Google Scholar 

  100. Burnett AL, Becker RE. Immunophilin ligands promote penile neurogenesis and erection recovery after cavernous nerve injury. J Urol. 2004;171(1):495–500.

    Article  PubMed  CAS  Google Scholar 

  101. Bochinski D, Lin GT, Nunes L, et al. The effect of neural embryonic stem cell therapy in a rat model of cavernosal nerve injury. BJU Int. 2004;94(6):904–9.

    Article  PubMed  Google Scholar 

  102. Fall PA, Izikki M, Tu L, et al. Apoptosis and effects of intracavernous bone marrow cell injection in a rat model of postprostatectomy erectile dysfunction. Eur Urol. 2009;56(4):716–25.

    Article  PubMed  Google Scholar 

  103. Kendirci M, Trost L, Bakondi B, et al. Transplantation of nonhematopoietic adult bone marrow stem/progenitor cells isolated by p75 nerve growth factor receptor into the penis rescues erectile function in a rat model of cavernous nerve injury. J Urol. 2010;184(4):1560–6. Epub 2010 Aug 21.

    Article  PubMed  Google Scholar 

  104. Albersen M, Lue TF. Re: transplantation of nonhematopoietic adult bone marrow stem/progenitor cells isolated by p75 nerve growth factor receptor into the penis rescues erectile function in a Rat model of cavernous nerve injury M. Kendirci, L. Trost, B. Bakondi et al. J Urol. 2010;184:1560–6. J Urol. 2011 Jan 20.

    Article  Google Scholar 

  105. Fandel TM, Albersen M, Lin G, et al. Tracking of injected adipose tissue-derived stem cells after cavernous nerve injury in rats: injury-induced homing to the major pelvic ganglion. J Urol. 2010;183(4 suppl):e61.

    Article  Google Scholar 

  106. Bella AJ, Garcia MM, Lin G, et al. Adult adipose tissue derived stem cells enhance neurite outgrowth from the major pelvic ganglion of the rat. CUAJ. 2007;1:200.

    Google Scholar 

  107. Zhang H, Yang R, Wang Z, et al. Adipose tissue-derived stem cells secrete cxcl5 cytokine with neurotrophic effects on cavernous nerve regeneration. J Sex Med. 2011;8(2):437–46.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Laboratory of Experimental Urology, Department of Urology, University Hospitals Leuven, Herestraat 49, Leuven, BE-3000, Belgium

    Maarten Albersen M.D. Ph.D.

  2. Department of Urology, University of California, San Francisco, 400 Parnassus Avenue, A633, San Francisco, 94143-0738, CA, USA

    Tom F. Lue M.D., ScD (Hon)

Authors
  1. Maarten Albersen M.D. Ph.D.
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  2. Tom F. Lue M.D., ScD (Hon)
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Correspondence to Maarten Albersen M.D. Ph.D. .

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Editors and Affiliations

  1. New York Presbyterian Hospital, Brady Urologic Health Center, Weill Cornell Medical Center, East 68th Street 525, New York, 10021, New York, USA

    Ashutosh Tewari

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© 2013 Springer-Verlag London

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Albersen, M., Lue, T.F. (2013). Erectile Dysfunction. In: Tewari, A. (eds) Prostate Cancer: A Comprehensive Perspective. Springer, London. https://doi.org/10.1007/978-1-4471-2864-9_81

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  • DOI: https://doi.org/10.1007/978-1-4471-2864-9_81

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