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Local therapies to heal the penis: fact or fiction?Kim EDJ Androl 2009[Jul]; 30 (4): 384-90Penile rehabilitation has been an area of intense study and debate over the last decade. Interest in this topic was stimulated by the observation that erectile dysfunction remained a significant problem after radical prostatectomy despite meticulous nerve-sparing technique. Smooth muscle alterations and fibrotic changes in the penis were identified as the underlying causes of penile atrophy, veno-occlusive dysfunction, and Peyronie's-like changes that were observed after surgery. Initial observations that intracavernous injection therapies used on a regular basis postoperatively resulted in improvements in the return of spontaneous erectile function led to the development of penile rehabilitation protocols. Chronic dosing of oral type V phosphodiesterase inhibitors is now commonly used by urologists after radical prostatectomy despite a lack of convincing evidence from randomized, placebo-controlled clinical trials. Use of local therapies to heal the penis may have applications beyond the postprostatectomy patient. This article reviews the current evidence behind penile rehabilitation therapy.|Alprostadil/therapeutic use[MESH]|Animals[MESH]|Clinical Trials as Topic[MESH]|Humans[MESH]|Male[MESH]|Penile Erection/drug effects[MESH]|Penis/drug effects/*surgery[MESH]|Phosphodiesterase 5 Inhibitors[MESH]|Phosphodiesterase Inhibitors/*therapeutic use[MESH]|Piperazines/therapeutic use[MESH]|Prostatectomy/adverse effects/*rehabilitation[MESH]|Purines/therapeutic use[MESH]|Sildenafil Citrate[MESH]|Sulfones/therapeutic use[MESH] |
