Management of treatment-related sexual complications in cancer care: evidence for erectile function recovery and penile rehabilitation after radical prostatectomy in prostate cancer survivorship

ABSTRACT Introduction: Radical prostatectomy adversely affects patient’s sexual function and quality of life. While several preventive and treatment strategies for the preservation and recovery of sexual function are available, no widely adopted specific recommendation or consensus guidelines exist regarding the optimal rehabilitation or treatment protocol. Areas covered: This article provides a scientific review on post-prostatectomy related erectile dysfunction and explores the various treatment strategies to preserve and/or restore penile erection, as well as addresses the psychosexual issues in men who wish to remain sexually active. Expert opinion/commentary: Penile rehabilitation programs are common in clinical practice despite no definitive evidence to support their use or the best treatment strategy. The role of penile rehabilitation is evolving, and it is generally agreed that treatment should be initiated as soon as possible to protect and/or prevent corporal endothelial and smooth muscle damage. Psychological and sexual counselling is equally important in assisting the patient in maintaining and/or recovering his sexual function. The current treatment strategy should offer prostate cancer survivor a perspective that de-emphasizes the solely biomedical approach to erectile recovery but addresses sexual issues from a more holistic approach encompassing biopsychosocial perspective.