前列腺癌根治术后勃起功能障碍的应对策略

Strategies for coping with erectile dysfunction after radical prostatectomy

勃起功能障碍(erectile dysfunction,ED)是前列腺癌根治术(radical prostatectomy,RP)后最常见的并发症之一,其关键原因是术中不可避免的损伤勃起神经,并由此引发术后阴茎海绵体血管内皮、平滑肌和静脉闭塞机制的损伤。如何应对RP术后ED的问题成为当今泌尿外科的热点问题。本文通过查阅文献,从比较不同RP术式对ED发生率的影响,分析影响术后ED恢复的因素、阴茎康复概念及开展时机、术后ED的管理方法等角度进行综述,归纳总结应对RP术后ED的策略,以期为临床泌尿外科/男科医师提供参考,为改善患者术后生活质量提供思路。

Erectile dysfunction(ED)is one of the most common con^lications after radical prostatectomy(RP).The key reason for ED post-surgery is the inevitable injuryto the erectile nerve during siargery,which leads to damage to the vascular endothelial,smooth muscles,and the occlusion mechanism of the penile.How to address the issue of ED after RP surgery has become a hot topic in urology today.This article reviews the impact of different RP procedures on the incidence of ED through the literature review,analyzes the factors that affect postoperative ED recovery,the concept and timing of penile rehabilitation,and the management methods of postoperative ED.It summarizes the strategies for dealing with postoperative ED after RP surgery,in order to provide reference for clinical xorologists/andrologists and provide ideas for improving the quality of life of patients after surgery.