Sexual Rehabilitation After Treatment for Prostate Cancer-Part 2: Recommendations From the Fourth International Consultation for Sexual Medicine (ICSM 2015)
Sexual Rehabilitation After Treatment for Prostate Cancer-Part 2: Recommendations From the Fourth International Consultation for Sexual Medicine (ICSM 2015)
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DOI：
10.1016/j.jsxm.2016.11.324
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发表时间：
2017-03-01
影响因子：
3.5
通讯作者：
Khera, Mohit
中科院分区：
文献类型：
--
作者：
Salonia, Andrea;Adaikan, Ganesh;Khera, Mohit
前言：前列腺癌根治术后患者普遍存在性功能障碍。目的：提供2015年国际性医学咨询(ICSM)关于前列腺癌根治术后勃起功能障碍处理策略的建议，并分析除勃起功能障碍外的其他性功能障碍。方法：利用Google和PubMed数据库对截至2016年8月发表的英文原创和综述文章进行文献检索。主要观察指标：在全面分析文献和委员会共识的基础上，提供证据水平(LES)和建议等级(GRS)。结果：ICSM 2015年关于RP术后性康复的委员会提供了9项建议。建议6指出，术后勃起功能的恢复可能需要数年时间(LE=2，GR=C)。建议7指出，关于使用磷酸二酯酶5型抑制剂进行阴茎康复是否能促进自发勃起的恢复，存在相互矛盾的数据(LE=1，GR=A)。建议8指出，这些数据不足以支持作为阴茎康复最佳方案的任何具体方案(LE=3，GR=C)。建议9指出，接受RP(任何技术)的男性除了勃起功能障碍外，还存在性变化的风险，包括性欲下降、性高潮改变、人工授精、类Peyronie病和阴茎大小改变(LE=2，GR=B)。结论：本文讨论了ICSM 2015年关于RP术后性康复委员会的建议6至9。版权所有(C)2017，国际性医学学会。爱思唯尔公司出版，版权所有。
Introduction: Sexual dysfunction is common in patients after radical prostatectomy (RP) for prostate cancer.Aim: To provide the International Consultation for Sexual Medicine (ICSM) 2015 recommendations concerning management strategies for post-RP erectile function impairment and to analyze post-RP sexual dysfunction other than erectile dysfunction.Methods: A literature search was performed using Google and PubMed database for English-language original and review articles published up to August 2016.Main Outcome Measures: Levels of evidence (LEs) and grades of recommendations (GRs) are provided based on a thorough analysis of the literature and committee consensus.Results: Nine recommendations are provided by the ICSM 2015 committee on sexual rehabilitation after RP. Recommendation 6 states that the recovery of postoperative erectile function can take several years (LE = 2, GR = C). Recommendation 7 states there are conflicting data as to whether penile rehabilitation with phosphodiesterase type 5 inhibitors improves recovery of spontaneous erections (LE = 1, GR = A). Recommendation 8 states that the data are inadequate to support any specific regimen as optimal for penile rehabilitation (LE = 3, GR = C). Recommendation 9 states that men undergoing RP (any technique) are at risk of sexual changes other than erectile dysfunction, including decreased libido, changes in orgasm, anejaculation, Peyronie-like disease, and changes in penile size (LE = 2, GR = B).Conclusion: This article discusses Recommendations 6 to 9 of the ICSM 2015 committee on sexual rehabilitation after RP. Copyright (C) 2017, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.