Skip to main content
SpringerLink
Log in

Future Therapies Applicable to Post-radical Pelvic Surgery Patients

  • Chapter
  • First Online:
Sexual Function in the Prostate Cancer Patient

Part of the book series: Current Clinical Urology ((CCU))

  • 499 Accesses

Abstract

Despite advances in operative technique and pharmacotherapy, erectile function is compromised in a significant proportion of men undergoing radical pelvic surgery for prostate, bladder, and colorectal malignancies. Strategies to decrease the incidence or severity of post-operative erectile dysfunction may include pre-operative optimization of erectile function, risk factors, and/or other protective maneuvers, elimination or modulation of neural, vascular and corporal smooth muscle injury, and the use of novel pharmacotherapies. In this chapter, future strategies to optimize the recovery of erectile function, and ultimately increase patient quality of life, are outlined.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Walsh, P.C., and Donker, P.C. (1982) Impotence following radical prostatectomy: insight into etiology and prevention. J. Urol. 128, 492–497.

    PubMed  CAS  Google Scholar 

  2. Seftel, A.D. (2006) Erectile dysfunction a decade later: another paradigm shift. J. Urol. 176, 10–11.

    Article  PubMed  Google Scholar 

  3. Mulhall, J., Land, S., Parker, M., Waters, W.B., and Flanigan, R.C. (2005) The use of an erectogenic pharmacotherapy regimen following radical prostatectomy improves recovery of spontaneous erectile function. J. Sex. Med. 2, 532–540.

    Article  PubMed  CAS  Google Scholar 

  4. Rozet, F., Galiano, M., Cathelineau, X., Barret, E., Cathala, N., and Vallancien, G. (2005) Extraperitoneal laparoscopic radical prostatectomy: a prospective evaluation of 600 cases. J. Urol. 174, 908–911.

    Article  PubMed  Google Scholar 

  5. Menon, M., Tewari, A., Peabody, J.O., Shrivastava, A., Kaul, S., Bhandari, A., and Hemal, A. (2004) Vattikuti Institute prostatectomy, a technique of robotic radical prostatectomy for management of localized carcinoma of the prostate: experience of over 1100 cases. Urol. Clin. N. Am. 31, 701–717.

    Article  Google Scholar 

  6. Dubbelman, Y.D., Dohle, G.R., and Schroder, F.H. (2008) Sexual function before and after radical retropubic prostatectomy: a systematic review of prognostic indicators for a successful outcome. Eur. Urol. 50, 711–718.

    Google Scholar 

  7. Kendirci, M., Bejma, J., and Hellstrom, W.J.G. (2006) Update on erectile dysfunction in prostate cancer patients. Curr. Opin. Urol. 16, 186–195.

    Article  PubMed  Google Scholar 

  8. Donohoe, J.F., Mullerad, M., Paduch, D.A., Kobylarz, K.A., Li, P.S., Scardino, P.T., and Mulhall, J.P. (2006) The functional and structural consequences of cavernous nerve injury in the rat model are ameliorated by sildenafil citrate. J. Urol. [abstract 1050].

    Google Scholar 

  9. Lin, G., Hayashi, N., Carrion, R., Chang, L.J., and Lue, T.F. (2005) Improving erectile function by silencing phosphodiesterase-5. J. Urol. 174, 1142–1148.

    Article  PubMed  CAS  Google Scholar 

  10. Bella, A., Lin, G., Tantiwongse, K., Garcia, M., Lin, C.S., Brant, W., and Lue, T. (2006) Brain-derived neurotrophic factor (BDNF) acts primarily via the JAK/STAT pathway to promote neurite growth in the major pelvic ganglion of the rat: Part 1. J. Sex. Med. 3, 815–820.

    Article  PubMed  CAS  Google Scholar 

  11. Burnett, A.L., Musicki, B., Jin, L., and Bivalacque, T.L. (2006) Nitric oxide/redox-based signalling as a therapeutic target for penile disorders. Expert Opin. Ther. Targets 10, 445–457.

    Article  PubMed  CAS  Google Scholar 

  12. Saad, F., Finelli, A., Dranitsaris, G., Goldenberg, L., Bagnell, S., Gleave, M., Fleshner, N., Canadian surgical wait times (SWAT) initiative. (2006) Does prolonging the time to prostate cancer surgery impact long-term cancer control: a systematic review of the literature. Can J. Urol. 13(Suppl 3), 16–24.

    PubMed  Google Scholar 

  13. Klotz, L. (2006) Active surveillance versus radical treatment for favorable-risk localized prostate cancer. Curr. Treat. Options Oncol. 7, 355–362.

    Article  PubMed  Google Scholar 

  14. Esposito, K., Ciotola, M., Giugliano, F., De Sio, M., Giugliano, G., D’Armiento, M., and Giugliano, D. (2006) Mediterranean diet improves erectile function in subjects with the metabolic syndrome. Int. J. Impot. Res. 18, 405–410.

    Article  PubMed  CAS  Google Scholar 

  15. Polsky, J.Y., Aronson, K.J., Heaton, J.P., and Adams, M.A. (2005) Smoking and other lifestyle factors in relation to erectile dysfunction. BJU Int. 96, 1355–1359.

    Article  PubMed  Google Scholar 

  16. Esposito, K., Giugliano, F., Di Palo, C., Giugliano, G., Marfella, R., D’Andrea, F., D’Armiento, M., and Giugliano, D. (2004) Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. JAMA 291, 2978–2984.

    Article  PubMed  CAS  Google Scholar 

  17. Bacon, C.G., Mittleman, M.A., Kawachi, I., Giovannucci, E., Glasser, D.B., and Rimm, E.B. (2006) A prospective study of risk factors for erectile dysfunction. J. Urol. 176, 217–221.

    Article  PubMed  Google Scholar 

  18. Kundu, S.D., Roehl, K.A., Eggener, S.E., Antenor, J.A., Han, M., and Catalona, W.J. (2006) Potency, continence, and complications in 3 477 consecutive radical retropubic prostatectomies. J. Urol. 172, 2227–2231.

    Article  Google Scholar 

  19. Borchers, H., Brehmer, B., Kirschner-Hermanns, R., Reineke, T., Tietze, L., and Jakse, G. (2006) Erectile dysfunction after non-nerve-sparing radical prostatectomy. Fact or fiction? Urol. Int. 76, 213–216.

    Article  PubMed  Google Scholar 

  20. Kendirci, M., Bejma, J., and Hellstrom, W.J.G. (2006) Update on erectile dysfunction in prostate cancer patients. Curr. Opin. Urol. 16, 186–195.

    Article  PubMed  Google Scholar 

  21. Nomura, H., Tator, C.H., and Shoichet, M.S. (2006) Bioengineered strategies for spinal cord repair. J. Neurotrauma. 23, 496–507.

    Article  PubMed  Google Scholar 

  22. May, F., Weidner, N., Matiasek, K., Caspers, C., Mrva, T., Vroemen, M., et al. (2004) Schwann cell seeded guidance tubes restore erectile function after ablation of cavernous nerves in rats. J. Urol. 172, 374.

    Article  PubMed  CAS  Google Scholar 

  23. Burnett, A.L., and Lue, T.F. (2006) Neuromodulatory therapy to improve erectile function outcomes after pelvic surgery. J. Urol. 176, 882–887.

    Article  PubMed  Google Scholar 

  24. Syme, D.B.Y., Corcoran, N.M., Bouchier-Hayes, D.M., and Costello, A.J. (2006) Hope springs eternal: cavernosal nerve regeneration. BJU Int. 97, 17–21.

    Article  PubMed  Google Scholar 

  25. Bannowsky, A., Schulze, H., van der Horst, C., Seif, C., Braun, P.M., and Junesmann, K.-P. (2006) Nocturnal tumescence: a parameter for postoperative erectile integrity after nerve sparing radical prostatectomy. J. Urol. 175, 2214–2217.

    Article  PubMed  Google Scholar 

  26. Mulhall, J.P., Slovick, R., Hotaling, J., Aviv, N., Valenzuela, R., Waters, W.B., and Flanigan, R.C. (2002) Erectile dysfunction after radical prostatectomy: hemodynamic profiles and their correlation with the recovery of erectile function. J. Urol. 167, 1371–1375.

    Article  PubMed  Google Scholar 

  27. Gontero, P., Fontana, F., Bagnasacco, A., Panella, M., Kocjancic, E., Pretti, G., and Frea, B. (2003) Is there an optimal time for intracavernous prostaglandin E1 rehabilitation following nonnerve sparing radical prostatectomy? Results from a hemodynamic prospective study. J. Urol. 169, 2166–2169.

    Article  PubMed  Google Scholar 

  28. Titta, M., Tavolini, I.M., Moro, F.D., Cisternino, A., and Bassi, P. (2006 Mar) Sexual counseling improved erectile rehabilitation after non-nerve-sparing radical retropubic prostatectomy or cystectomy-results of a randomized prospective study. J. Sex. Med. 3(2), 267–273.

    Article  PubMed  Google Scholar 

  29. Fandel, T., Bella, A.J., Tantiwongse, K., Garcia, M., Nunes, L., Thuroff, J.W., Tanagho, E.A., and Lue, T.F. (2006) The effect of intracavernous growth differentiation factor-5 in a rat model of cavernous nerve injury. BJU Int. [epub ahead of print].

    Google Scholar 

  30. Vignozzi, L., Filippi, S., Morelli, A., Ambrosini, S., Luconi, M., Vanneli, G.B., Donati, S., Crescioli, C., Zhang, X.H., Mirone, V., Forti, G., and Maggi, M. (2006) Effect of chronic tadalafil administration on penile hypoxia induced by cavernous neurotomy in the rat. J. Sex. Med. 3, 419–431.

    Article  PubMed  CAS  Google Scholar 

  31. Pilatz, A., Schultheiss, D., Gabouev, A.I., Schlote, N., Mertsching, H., Jonas, U., and Stief, C.G. (2005) Isolation of primary endothelial and stromal cell cultures of the corpus cavernosum penis for basic research and tissue engineering. Eur. Urol. 47, 710–718.

    Article  PubMed  Google Scholar 

  32. Falke, G., Yoo, J.J., Kwon, T.G., Moreland, R., and Atala, A. (2003 Oct) Formation of corporal tissue architecture in vivo using human cavernosal muscle and endothelial cells seeded on collagen matrices. Tissue Eng. 9(5), 871–879.

    Article  PubMed  CAS  Google Scholar 

  33. Kwon, T.G., Yo, J.J., and Atala, A. (2002 Oct) Autologous penile corpora cavernosa replacement using tissue engineering techniques. J. Urol. 168(4 Pt 2), 1754–1758.

    PubMed  CAS  Google Scholar 

  34. Melman, A. (2006) Gene transfer for the therapy of erectile dysfunction: progress in the 21st century. Int. J. Impot. Res. 18, 19–25.

    Article  PubMed  CAS  Google Scholar 

  35. Schiff, J.D., and Melman, A. (2006) Ion channel gene therapy for smooth muscle disorders: relaxing smooth muscles to treat erectile dysfunction. Assay Drug Dev. Technol. 4, 89–95.

    Article  PubMed  CAS  Google Scholar 

  36. Melman, A., Bar-Chama, N., McCullough, A., Davies, K., and Christ, G. (2005) The first human trial for gene transfer therapy for the treatment of erectile dysfunction: preliminary results. Eur. Urol. 48, 314–318.

    Article  PubMed  CAS  Google Scholar 

  37. Deng, W., Bivalacqua, T.J., Hellstrom, W.J.G., and Kadowitz, P.J. (2005) Gene and stem cell therapy for erectile dysfunction. Int. J. Impot. Res. 17, S57–S63.

    Article  PubMed  CAS  Google Scholar 

  38. Bunnell, B.A., Deng, W., Robinson, C.M., Waldron, P.R., Bivalaqua, T.J., Baber, S.R., Hymann, A.L., and Kadowitz, P.J. (2005) Potential application for mesenchymal stem cells in the treatment of cardiovascular disease. Can. J. Physiol. Pharmacol. 83, 529–539.

    Article  PubMed  CAS  Google Scholar 

  39. Bochinski, D., Lin, G.T., Nunes, L., Carrion, R., Rahman, N., Lin C.-S., and Lue, T.F. (2004) The effect of neural embryonic stem cell therapy in a rat model of cavernosal nerve injury. BJU Int. 94, 904–909.

    Article  PubMed  Google Scholar 

  40. Poulter, M.O., Payne, K.B., and Steiner, J.P. (2004) Neuroimmunophilins: a novel drug therapy for the reversal of neurodegenerative disease? Neuroscience 128, 1–6.

    Article  PubMed  CAS  Google Scholar 

  41. Hayashi, N., Minor, T.X., Carrion, R., Price, R., Nunes, L., and Lue, T.F. (2006) The effect of FK1706 on erectile function following bilateral cavernous nerve crush injury in a rat model. J. Urol. 176, 824–829.

    Article  PubMed  CAS  Google Scholar 

  42. Lin, G., Bella, A.J., Lue, T.F., and Lin, C.S. (2006) Brain-derived neurotrophic factor (BDNF) acts primarily via the JAK/STAT pathway to promote neurite growth in the major pelvic ganglion of the rat: Part 2. J. Sex. Med. 3, 821–829.

    Article  PubMed  CAS  Google Scholar 

  43. Bella, A.J., Brant, W.O., and Brock, G.B. (2006) Contemporary intracavernous pharmacotherapy for erectile dysfunction in the aging male. Aging Health 2, 559–570.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Assistant Professor Urology and Director of Basic Urologic Research, Associate Scientist, Neuroscience, University of Ottawa, Ottawa, Canada

    Anthony J. Bella

  2. Northstar Urology, Vail, CO, USA

    William O. Brant

  3. Professor and Vice Chair Urology, Emil Tanagho Endowed Chair in Clinical Urology, University of California, San Francisco, San Francisco, CA, USA

    Tom F. Lue

Authors
  1. Anthony J. Bella
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. William O. Brant
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tom F. Lue
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

    Rights and permissions

    Reprints and permissions

    Copyright information

    © 2009 Humana Press, a part of Springer Science+Business Media, LLC

    About this chapter

    Cite this chapter

    Bella, A.J., Brant, W.O., Lue, T.F. (2009). Future Therapies Applicable to Post-radical Pelvic Surgery Patients. In: Mulhall, J. (eds) Sexual Function in the Prostate Cancer Patient. Current Clinical Urology. Humana Press. https://doi.org/10.1007/978-1-60327-555-2_16

    Download citation

    • DOI: https://doi.org/10.1007/978-1-60327-555-2_16

    • Published:

    • Publisher Name: Humana Press

    • Print ISBN: 978-1-60327-554-5

    • Online ISBN: 978-1-60327-555-2

    • eBook Packages: MedicineMedicine (R0)

    Publish with us

    Policies and ethics

    Search

    Navigation