• radical prostatectomy
• erectile dysfunction
• prescriptions
• prostate cancer
• epidemiology
• clinical outcomes

• Humans
• Male
• Prostatectomy/adverse effects
• Prostatectomy/methods
• Erectile Dysfunction/drug therapy
• Erectile Dysfunction/etiology
• Phosphodiesterase 5 Inhibitors/therapeutic use
• Prostatic Neoplasms/surgery
• Prostatic Neoplasms/pathology
• Middle Aged
• Aged
• Registries
• Drug Prescriptions/statistics & numerical data
• Postoperative Complications/drug therapy
• Postoperative Complications/etiology
• Practice Patterns, Physicians'/statistics & numerical data
• Denmark/epidemiology

• erectile dysfunction
• penile duplex doppler ultrasound
• radical prostatectomy
• sleep apnea

• Humans
• Male
• Prostatectomy/adverse effects
• Prostatectomy/methods
• Middle Aged
• Penis/innervation
• Penis/blood supply
• Erectile Dysfunction/etiology
• Ultrasonography, Doppler, Duplex
• Comorbidity
• Postoperative Complications
• Sleep Apnea, Obstructive/surgery
• Impotence, Vasculogenic
• Risk Factors
• Organ Sparing Treatments/methods
• Prostatic Neoplasms/surgery

• P30-CA008748 Memorial Sloan Kettering Cancer Center
• P50 CA092629 NCI NIH HHS
• P30 CA008748 NCI NIH HHS
• NIH HHS
• ME-2018C2-13253 Patient-Centered Outcomes Research Institute
• Prostate Cancer Foundation
• Sidney Kimmel Center for Prostate and Urologic Cancers
• National Institutes of Health
• National Cancer Institute

• Erectile function
• Lateral approach
• Prostate cancer
• Robot-assisted radical prostatectomy
• Urinary continence

• Male
• Humans
• Robotic Surgical Procedures/methods
• Prostate/surgery
• Robotics
• Urinary Incontinence/etiology
• Urinary Incontinence/prevention & control
• Retrospective Studies
• Prostatectomy/methods
• Prostatic Neoplasms/surgery
• Prostatic Neoplasms/complications
• Surgeons
• Treatment Outcome

• Università Politecnica delle Marche

• Bibliometric
• Detection
• Raman spectroscopy
• Surface-enhanced Raman scattering
• Urological tumors

• Male
• Humans
• Spectrum Analysis, Raman
• China
• Urologic Neoplasms/diagnosis
• Bibliometrics
• Biomarkers, Tumor

• Humans
• Male
• Sexual Health
• Quality of Life
• Gender Identity
• Sexual Behavior
• Sexual and Gender Minorities
• Sexual Dysfunction, Physiological/etiology
• Sexual Dysfunction, Physiological/therapy
• Prostatic Neoplasms/therapy

• DP5 OD031876 NIH HHS

• Adiposity
• Cohort Studies
• Erectile Dysfunction/epidemiology
• Erectile Dysfunction/etiology
• Humans
• Longitudinal Studies
• Male
• Prospective Studies
• Prostatectomy
• Prostatic Neoplasms/complications
• Prostatic Neoplasms/surgery
• Recovery of Function

• RALP
• SHIM score
• age
• nerve sparing
• potency outcomes

To assess whether the timing of post-operative Phosphodiesterase Inhibitor (PDE5i) therapy after Robot-Assisted Radical Prostatectomy (RARP) is associated with a change in early erectile function (EF) outcomes, continence or safety outcomes. Data were prospectively collected from a single surgeon in one tertiary centre. 158 patients were treated with PDE5i therapy post RARP over a 2-year period. PDE5i therapy was started: immediately (day 1–2) post-op in 29%, early (day 3–14) post-op in 37% and late (after day 14) post-op in 34%. EPIC-26 EF scores were collected pre-op and post-op. There were no significant differences in pre-operative characteristics between the therapy groups. Drop in EF scores and percentage return to baseline for unilateral nerve sparing was, respectively, 9 and 11.1% of immediate therapy, 7 and 14.8% of early therapy and 9.7 and 9.5% of late therapy (p = 0.9 and p = 0.6). For bilateral nerve sparing, this was, respectively, 3.5 and 42.9% immediate therapy, 5.5 and 35.5% early therapy and 7.3 and 25% late therapy (p = 0.017 and p = 0.045). Pad free and social continence were achieved in 54% and 37% of those receiving immediate therapy, 60% and 33% for early therapy and 26% and 54% for late therapy. There were no differences in compliance, complication or readmission outcomes. In patients with bilateral nerve sparing RARP, immediate post-operative PDE5i therapy can protect EF and improve early continence outcomes. Therefore, immediate PDE5i therapy should be considered in patients following nerve sparing RARP to maximise functional outcomes.

• Continence
• Laparoscopic prostatectomy.
• Potency
• RALP
• Radical prostatectomy

Erectile dysfunction (ED) is one of the main functional complications of surgical resections of the rectum due to rectal cancers or inflammatory bowel disease (IBD). The present systematic review aimed at revising ED management strategies applied after rectal resections and their efficacy in terms of improvement of the International Index of Erectile Function (IIEF) score. A literature search was conducted on Medline, EMBASE, Scopus, and Cochrane databases by two independent reviewers following the PRISMA guidelines. Randomized and nonrandomized controlled trials (RCTs, NRCTs), case-control studies, and case series evaluating medical or surgical therapies for ED diagnosed after rectal surgery for both benign and malignant pathologies were eligible for inclusion.

Out of 1028 articles initially identified, only five met the inclusion criteria: two RCTs comparing oral phosphodiesterase type-5 inhibitor (PDE-5i) versus placebo; one NRCT comparing PDE-5i versus PDE-5i + vacuum erection devices (VEDs) versus control; and two before-after studies on PDE-5i. A total of 253 (82.7%) rectal cancer patients and 53 (17.3%) IBD patients were included. Based on two RCTs, PDE-5i significantly improved IIEF compared to placebo at 3 months (SMD = 1.07; 95% CI [0.65, 1.48]; p < .00001; I² = 39%). Improved IIEF was also reported with PDE-5i + VED at 12 months. There is a paucity of articles in the literature that specifically assess efficacy of ED treatments after rectal surgery. Many alternative treatment strategies to PDE-5is remain to be investigated. Future studies should implement standardized preoperative, postoperative, and follow-up sexual function assessment in patients undergoing rectal resections.

• Sexual dysfunction
• men’s health
• rectal surgery
• total mesorectal excision

Research on prostate cancer survivorship patients has largely been on oncological outcome, incontinence and erectile dysfunction, with less data on the relationship between prostate cancer, bladder function and mental health. This study aims to elucidate the prevalence of lower urinary tract symptoms (LUTS), overactive bladder (OAB), sexual dysfunction, depression and anxiety in Canadian men with newly diagnosed localised prostate cancer.

This is a single-centre prospective cross-sectional study of men with newly diagnosed localized prostate cancer recruited from June 2017 to July 2018. The patient-reported outcomes (PRO) instruments used in this study included the international prostate symptoms score (IPSS), OAB-V8, EQ-5D™, and the Expanded Prostate Cancer Index Composite short form (EPIC-26). Clinico-pathological data were extracted from medical records. The prevalence of LUTS, OAB, sexual dysfunction, depression and anxiety were determined from the PROs.

A total of 83 patients were included in this study. The median age was 63. Based on IPSS scores, 55.3% of men had mild LUTS, 36.8% had moderate LUTS and 7.9% had severe LUTS. Based on OAB-V8 scores, 55.8% of men had a score of 8 or higher, suggestive of OAB. Only 55.8% of men reported erections adequate for intercourse. 23.1% of men reported to have a moderate to big problem with depression, and 28.8% of men reported to have a degree of anxiety or depression.

OAB is a significant problem in men with newly diagnosed localized prostate cancer, with a prevalence of 55.8% based on this study. Baseline sexual dysfunction, anxiety and depression are also prevalent in this population.

• Erectile dysfunction
• epidemiology
• lower urinary tract symptoms (LUTS)
• overactive
• prostate neoplasms
• urinary bladder

• erectile dysfunction
• prostatectomy
• prostatic neoplasms
• sildenafil citrate
• therapeutics

Robotic radical prostatectomy (RARP) is a standardized treatment for localized prostate cancer, which provides better functional outcomes and similar oncological outcomes compared to open approaches. Here, we share our experience of 12,000 RARPs by describing the outcomes of the procedure in terms of positive surgical margin (PSM), continence, and potency as well as by presenting our detailed surgical technique with recent modifications. On cancer control, the PSM rates were 5.8% and 26.1% in T2 and T3, respectively. On the premise of not compromising oncologic outcomes, a tailored approach to individual patients is essential. Even if an extracapsular extension is suspected, neurovascular bundle (NVB) tailoring can be applied using an anatomical landmark to preserve maximal nerve tissue with a negative margin. We developed a nomogram as a useful tool for deciding the degree of tailoring. For improvements of functional outcomes, we used athermal retrograde early release with a toggling technique, wherein the nerve dissection from the bottom helps with blood loss and allows for smooth NVB releasing. Additionally, we recently performed a new minimal apical dissection/lateral prostatic fascia preservation technique. As a result, our 1-week continence rate was 37% and the 6-week rate was 77.6%. In addition, the potency rates in our study were 69%, 82%, and 92% at 3 months, 6 months, and 1 year, respectively (preoperative Sexual Health Inventory for Men scores >21 & bilateral full nerve spared).

• Prostate
• Prostatectomy
• Prostatic neoplasms
• Robotics

• nomogram
• prostate cancer
• robotic prostatectomy
• sexual function

• Genitourinary dysfunction
• Injury to the pelvic autonomic nerves
• Rectal cancer
• Total Mesorectal excision

• Adenocarcinoma/surgery
• Adult
• Digestive System Surgical Procedures/methods
• Humans
• Laparoscopy
• Male
• Mesenteric Artery, Inferior
• Mesenteric Veins
• Postoperative Complications/prevention & control
• Prospective Studies
• Rectal Neoplasms/surgery
• Sexual Dysfunction, Physiological/prevention & control

• Cáncer de próstata
• Disfunción eréctil
• Ecografía doppler de pene
• Erectile dysfunction
• Penile doppler ultrasound
• Prostate cancer

• Erectile function
• Prostate cancer
• Radiotherapy
• Sexual outcomes

• Raman spectroscopy
• prostate cancer
• robotic surgery

• Computer Systems
• Equipment Design
• Humans
• Laparoscopy/methods
• Male
• Neoplasm Recurrence, Local
• Phantoms, Imaging
• Prostate/surgery
• Prostatectomy/instrumentation
• Prostatectomy/methods
• Prostatic Neoplasms/surgery
• Reproducibility of Results
• Robotic Surgical Procedures/instrumentation
• Robotic Surgical Procedures/methods
• Spectrum Analysis, Raman/instrumentation
• Spectrum Analysis, Raman/methods

• erectile dysfunction
• prostate cancer
• radical prostatectomy
• urinary incontinence

• Erectile dysfunction
• IIEF
• Nerve-sparing
• Prediction model
• Prostatectomy
• RARP

Recently, the Expanded Prostate Cancer Index Composite 26-item version (EPIC-26) was recommended for the assessment of adverse effects after the treatment of prostate cancer without clear reasons. This decision encouraged us to review the questionnaire development from the UCLA Prostate Cancer Index (UCLA-PCI) to the EPIC-16 CP with a focus on psychometric properties. We also reviewed PubMed for papers concerning such properties of the EPIC-26 since 2012 (latest review in 2011). Finally, we examined the psychometric properties of the EPIC-26 in a sample of Norwegian males treated with robot-assisted laparoscopic prostatectomy (RALP).

This study used three methods: (1) Comparison of the content of the UCLA-PCI, EPIC-50, EPIC-26, and EPIC-16 CP; (2) Review of EPIC-26 and EPIC-16 CP papers in PubMed from 2012 to 2016, identifying papers reporting on the psychometric properties of these questionnaires; and (3) Psychometric examination of the EPIC-26 rating in 651 Norwegian men treated with RALP at a mean of 3.2 years post-surgery.

The questionnaire development showed a significant increase in bother versus function items, and the EPIC-26 contains eight function and 18 bother items. Twelve papers concerning the EPIC-26 available on PubMed since 2012 support the psychometric properties of the EPIC-26. The Norwegian EPIC-26 findings supported the psychometric properties of the EPIC-26, but suggested six subdomains both by exploratory and confirmatory factor analyses.

In general our examinations supported the adequate psychometric properties of the EPIC-26, although the factor structure, construct and predictive validity of the instrument should be examined further.

• Adverse effects
• Patient-reported outcome measures
• Prostate cancer
• The UCLA prostate cancer index
• The expanded prostate cancer index composite 26 item version

• extracapsular extension
• nomogram
• prostate
• prostate cancer
• robotic prostatectomy
• staging

• Cancer de la prostate
• Dysfonction érectile
• Erectile dysfunction
• Laparoscopie
• Laparoscopy
• Prostate cancer
• Prostatectomie
• Prostatectomy
• Robotic
• Robotique

• Artificial urinary sphincter
• Ballons Pro-ACT
• Bandelette sous-urétrale
• Cancer de la prostate
• Cell therapy
• Chirurgie
• Continence
• Couple
• Incontinence
• Incontinence urinaire
• Potency
• Pro-ACT
• Prostate cancer
• Prostatectomie totale
• Radical prostatectomy
• Rehabilitation
• Rééducation
• Sexuality
• Sexualité
• Sphincter urinaire artificiel
• Thérapie cellulaire
• Urethral sling
• Urinary
• Érection

In the current era of the early diagnosis of prostate cancer (PCa) and the development of minimally invasive surgical techniques, erectile dysfunction (ED) represents an important issue, with up to 68% of patients who undergo radical prostatectomy (RP) complaining of postoperative erectile function (EF) impairment. In this context, it is crucial to comprehensively consider all factors possibly associated with the prevention of post-RP ED throughout the entire clinical management of PCa patients. A careful assessment of both oncological and functional baseline characteristics should be carried out for each patient preoperatively. Baseline EF, together with age and the overall burden of comorbidities, has been strongly associated with the chance of post-RP EF recovery. With this goal in mind, internationally validated psychometric instruments are preferable for ensuring proper baseline EF evaluations, and questionnaires should be administered at the proper time before surgery. Careful preoperative counselling is also required, both to respect the patient's wishes and to avoid false expectations regarding eventual recovery of baseline EF. The advent of robotic surgery has led to improvements in the knowledge of prostate surgical anatomy, as reflected by the formal redefinition of nerve-sparing techniques. Overall, comparative studies have shown significantly better EF outcomes for robotic RP than for open techniques, although data from prospective trials have not always been consistent. Preclinical data and several prospective randomized trials have demonstrated the value of treating patients with oral phosphodiesterase 5 inhibitors (PDE5is) after surgery, with the concomitant potential benefit of early re-oxygenation of the erectile tissue, which appears to be crucial for avoiding the eventual penile structural changes that are associated with postoperative neuropraxia and ultimately result in severe ED. For patients who do not properly respond to PDE5is, proper counselling regarding intracavernous treatment should be considered, along with the further possibility of surgical treatment for ED involving the implantation of a penile prosthesis.

• Erectile dysfunction
• Phosphodiesterase 5 inhibitors
• Prostatectomy
• Prostatic neoplasms
• Robotics

• Clinical trials
• Decision-tree analysis
• Erectile dysfunction
• Nerve-sparing radical prostatectomy
• Phosphodiesterase type 5 inhibitors
• Predictors
• Prostate cancer
• Rehabilitation
• Tadalafil

Sexual dysfunction is common in patients with prostate cancer (PC) following radical prostatectomy (RP). Review the available literature concerning prevention and management strategies for post-RP erectile function (EF) impairment in terms of preoperative patient characteristics, intra and postoperative factors that may influence EF recovery, and postoperative treatments for erectile dysfunction (ED). A literature search was performed using Google and PubMed database for English-language original and review articles, either published or e-published up to July 2013. The literature still demonstrates a great inconsistency in the definition of what is considered normal EF both before and after RP. Thus, using validated psychometric instruments with recognized cut-offs for normalcy and severity during the pre- and post-operative evaluation should be routinely considered. Therefore, a comprehensive discussion with the patient about the true prevalence of postoperative ED, the concept of spontaneous or pharmacologically-assisted erections, and the difference between “back to baseline” EF and “erections adequate enough to have successful intercourse” clearly emerge as key issues in the eventual understanding of post-RP ED prevention and promotion of satisfactory EF recovery. Patient factors (including age, baseline EF, comorbid conditions status), cancer selection (non- vs. uni- vs. bilateral nerve-sparing), type of surgery (i.e., intra vs. inter vs. extrafascial surgeries), surgical techniques (i.e., open, laparoscopic and robotically-assisted RP), and surgeon factors (i.e., surgical volume and surgical skill) represent the key significant contributors to EF recovery. A number of preclinical and clinical data show that rehabilitation and treatment in due time are undoubtedly better than leaving the erectile tissue to its unassisted postoperative fate. The role of postoperative ED treatment for those patients who received a non-nerve-sparing RP was also extensively discussed. Optimal outcomes are achieved mainly by the careful choice of the correct patient for the correct type of surgery. Despite a plethora of potential rehabilitative approaches, they should be only considered as “strategies”, since incontrovertible evidence of their effectiveness for improving natural EF recovery is limited. Conversely, numerous effective therapeutic options are available for treating post-RP ED.

• Prostate cancer (PCa)
• erectile dysfunction (ED)
• erectile function (EF)
• radical prostatectomy (RP)

• Prostate cancer (PCa)
• penile rehabilitation
• phosphodiesterase type-5 inhibitors (PDE5-Is)
• radical prostatectomy (RP)
• sexual function

• Decision support techniques
• Neoplasms
• Risk
• Secondary prevention
• Survivors

• Alprostadil/therapeutic use
• Animals
• Erectile Dysfunction/rehabilitation
• Erectile Dysfunction/therapy
• Humans
• Male
• Pelvic Neoplasms/surgery
• Penis/drug effects
• Penis/physiopathology
• Phosphodiesterase 5 Inhibitors/therapeutic use
• Postoperative Complications/rehabilitation
• Postoperative Complications/therapy
• Prostatectomy/adverse effects
• Rectal Neoplasms/surgery
• Risk Factors
• Urologic Surgical Procedures/adverse effects

• Erectile dysfunction
• Penile rehabilitation
• Phosphodiesterase type 5 inhibitor
• Prostaglandin E1
• Prostate cancer