TY  - JOUR
A1  - Schoentgen, Nadja
A1  - Califano, Gianluigi
A1  - Manfredi, Celeste
A1  - Romero-Otero, Javier
A1  - Chun, Felix
A1  - Ouzaid, Idir
A1  - Hermieu, Jean-François
A1  - Xylinas, Evanguelos
A1  - Verze, Paolo
T1  - Is it worth starting sexual rehabilitation before radical prostatectomy? Results from a systematic review of the literature
T2  - Frontiers in Surgery
N2  - Background and Purpose: Sexual dysfunction (SD) is a frequent side effect associated with radical prostatectomy (RP) for prostate cancer (PCa). Some studies have showed the benefit associated with preoperative sexual rehabilitation (prehabilitation) and Enhanced Recovery After Surgery (ERAS) for RP, but no clear clinical recommendations are available yet. Our aim was to conduct a systematic review on sexual prehabilitation prior to RP for patients with a localized PCa and analyze the impact on postoperative sexual health compared with the standard post-operative care.
Methods: We performed a systematic review of the literature following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) recommendations.
Results: Four randomized control trials and one retrospective comparative study were included in the analyses. Three of the five studies showed an improved EF recovery post-RP in the prehabilitation group compared to the standard of care represented by: higher International Index of Erectile Function 5 score (IIEF5) or IIEF score (p < 0.0001) and a higher percentage of patients reporting return of EF based on the Sexual Encounter Profile (SEP) (56 vs. 24%, p = 0.007). Self-confidence, therapeutic alliance, and adherence to treatment were stronger for patients with preoperative consultations (p < 0.05) and EF recovery was better in cases of a higher number of follow-up visits (OR 4–5 visits vs. 1:12.19, p = 0.002).
Discussion: Despite heterogenous methods and high risks of bias in this systematic review, starting sexual rehabilitation prior to surgery seems to ensure better EF recovery. This prehabilitation should include information of both the patient and his or her partner, with a closer follow up and the use of a multimodal treatment approach that still remains to be defined and validated (oral medication, vacuum devices, pelvic floor muscle training, etc.).
KW  - prehabilitation
KW  - sexual rehabilitation
KW  - sexual dysfunction
KW  - radical prostatecomy
KW  - prostate cancer
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/62011
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-620119
SN  - 2296-875X
VL  - 8
IS  - art. 648345
SP  - 1
EP  - 9
PB  - Frontiers Media
CY  - Lausanne
ER  -