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Retzius-Sparing Robot-Assisted Radical Prostatectomy
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Orgasmic Dysfunction after Radical Prostatectomy.

Paolo Capogrosso1,2, Eugenio Ventimiglia1,3, Walter Cazzaniga1,3

  • 1Università Vita-Salute San Raffaele, Milan, Italy.

The World Journal of Men'S Health
|May 2, 2017
PubMed
Summary
This summary is machine-generated.

Radical prostatectomy (RP) can lead to significant orgasmic dysfunctions (ODs), including incontinence and pain, affecting many patients. Further research is needed to understand and manage these neglected side effects of RP.

Keywords:
OrgasmProstatectomyProstatic neoplasmUrinary incontinence

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Area of Science:

  • Urology
  • Sexual Medicine
  • Oncology

Background:

  • Radical prostatectomy (RP) is a common treatment for prostate cancer.
  • Beyond urinary incontinence and erectile dysfunction, other sexual function impairments, termed neglected side effects, can occur post-RP.
  • Orgasmic dysfunctions (ODs) are a significant, though often underassessed, group of these side effects.

Purpose of the Study:

  • To review the prevalence and pathophysiology of post-RP ODs.
  • To discuss potential treatment options for these conditions.
  • To highlight the need for increased awareness and counseling regarding ODs.

Main Methods:

  • Comprehensive literature review of studies on post-radical prostatectomy orgasmic dysfunction.
  • Analysis of reported prevalence rates for various ODs, including climacturia, orgasmic pain, and anorgasmia.
  • Examination of potential clinical and surgical factors associated with ODs.

Main Results:

  • Prevalence of orgasm-associated incontinence (climacturia) ranges from 20% to 93% post-RP.
  • Postoperative orgasmic pain affects up to 19% of patients, often referred to the penis.
  • Impaired orgasmic sensation or anorgasmia is reported by 33% to 77% of patients after RP.
  • Factors like age, nerve-sparing techniques, and robotic surgery show variable associations with OD risk, but data are limited.
  • Robust data on risk estimation and management strategies for post-RP ODs are lacking.

Conclusions:

  • Orgasmic dysfunctions are prevalent and impactful neglected side effects of radical prostatectomy.
  • Current understanding of physiopathology, risk factors, and effective treatments for post-RP ODs is limited.
  • Physicians must counsel patients pre- and post-operatively about the potential for distressing changes in sexual function, including ODs.