[Andrologic problems in prostatic carcinoma]

In our opinion, the attempt to save the sexuality and the erectile ability in a patient with a prostate cancer, in the respect of an absolute oncological radicality, should be recommended since potency represents for the patient a primary aspect in the quality of residual life. At the Institute of Urology of the University of Milan a study to identify pathogenetic mechanisms leading to erectile failure in the various phases of a prostate cancer was performed. From January 1988 to December 1993, 36 patients (range 50-60 years old) suffering from prostate cancer B1 stage (14 pts), B2 (20 pts) and C (2 pts) underwent to radical prostatectomy. Out of 24 pts reporting erectile ability before surgery, 10 was in B1 stage and underwent monolateral nerve-sparing technique. Out of these, 6 pts (60%) maintained the erection after the operation. The treatment with LHRH analogues weighted on loss of libido and erectile and erectile potent due to central androgenic delete. At our Institute 87 pts in treatment with LHRH analogues reported loss of erection in 80% of cases. In this group 22 underwent to an andrological examination. The exams (Dynamic penile Doppler, Dynamic Cavernosometry and stimulating test with intracavernous vasoactive drugs) confirm the absence of peripherical damages in the pathogenesis of the erectile dysfunction. Patient underwent radiotherapy develop a secondary impotence due to an obliterant progressive angioitis in a percentage ranging from 30 to 80%.(ABSTRACT TRUNCATED AT 250 WORDS)