Prostate cancer and sexual function.

Area of Science:

• Urology
• Oncology
• Men's Health

Background:

• Prostate cancer incidence is rising in Korean adult males, linked to Westernized diets and improved diagnostics like prostate-specific antigen (PSA) testing.
• Prostate cancer and its treatments, including surgery and hormonal therapy, frequently lead to erectile dysfunction (ED) and psychiatric disorders.
• ED post-radical prostatectomy is a significant concern, affecting sexual desire, intercourse frequency, and overall quality of life.

Purpose of the Study:

• To review the causes and impact of erectile dysfunction in prostate cancer patients.
• To discuss the factors influencing ED prognosis after radical prostatectomy.
• To explore current and emerging treatment strategies for post-prostatectomy erectile dysfunction.

Main Methods:

• Review of literature on prostate cancer, erectile dysfunction, and treatment outcomes.
• Analysis of factors contributing to nerve injury and penile hypoxia following radical prostatectomy.
• Examination of established and novel therapeutic interventions for ED recovery.

Main Results:

• Radical prostatectomy can cause ED through nerve injury, hypoxia, and anatomical changes.
• Prognosis for ED recovery depends on neurovascular bundle preservation, patient age, and pre-operative function.
• Treatments like intracavernosal injections, PDE5 inhibitors, vacuum devices, and testosterone replacement therapy show promise.

Conclusions:

• Erectile dysfunction is a common and significant side effect of prostate cancer treatment, particularly after radical prostatectomy.
• Preserving erectile function is crucial for patient quality of life.
• A range of therapies, including newer options like testosterone replacement, can improve ED recovery.