Prostatic irradiation-induced sexual dysfunction: A review and multidisciplinary guide to management in the radical radiotherapy era (Part II on Urological Management) |
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Institution: | 1. Urology, Medical University of South Carolina, Charleston, SC, United States;2. Life Sciences, BioFort Corp., Guaynabo, PR, United States;3. Urology, Weill Cornell Medicine, New York, NY, United States;4. Radiation Oncology, SUNY Downstate Health Sciences University, Brooklyn, NY, United States;5. Pharmacology and Toxicology, Ponce Health Sciences University, Ponce, PR, United States;6. Radiation Oncology, Weill Cornell Medicine, New York, NY, United States;7. Radiation Oncology, Indiana University, Indianapolis, IN, United States;8. Sexual and Reproductive Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States |
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Abstract: | Prostate cancer is the most common malignancy in men and the second leading cause of cancer-related death in men. Radiotherapy is a curative option that is administered via external beam radiation, brachytherapy, or in combination. Sexual dysfunction is a common toxicity following radiotherapy, similar to men undergoing radical prostatectomy, but the etiology is different. The pathophysiology of radiation-induced sexual dysfunction is multi-factorial, and the toxicity is a major cause of impaired quality of life among long-term prostate cancer survivors. Management of a patient’s sexual function during and after radiotherapy requires multidisciplinary coordination of care between radiation oncology, urology, psychiatry, pharmacy, and dermatology. This review provides a framework for clinicians to better understand prostatic radiotherapy-induced sexual dysfunction diagnosis, evaluation, and a patient-centered approach to toxicity preventive strategies and management. |
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Keywords: | Prostate cancer Erectile dysfunction Ejaculatory dysfunction Orgasmic dysfunction Radiation therapy Sexual Toxicities PDE-5i Vacuum erection device Intracavernosal Injections Penile Vibratory stimulation Penile prosthesis |
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