Erectile dysfunction associated with prostate cancer treatment and therapeutic advances: a narrative review

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background and objective The treatment of prostate cancer (PCa) often comes with the risk of erectile dysfunction (ED). As therapeutic technologies continue to advance, the incidence of ED and its treatment methods are also evolving. This paper aimed to provide a comprehensive analysis of the latest developments in PCa treatment, with a particular focus on its relationship with ED, and to review current innovative strategies for ED treatment. Methods This study conducted a literature search in databases including PubMed, Excerpta Medica, Web of Science, Scopus, and the Cochrane Library, using keywords including "prostate cancer", "active surveillance", "radiation therapy", "cryotherapy", "radical prostatectomy", "immunotherapy", "chemotherapy", "androgen deprivation therapy", "erectile dysfunction", and "therapeutic advances", to collect English-language literature published from 1966 to June 2024. Key content and findings Active surveillance (AS) strategies have significantly reduced the incidence of ED. Technological advancements such as radiation therapy (RT), precise delineation techniques, and improvements in cryotherapy equipment are all dedicated to reducing the risk of ED. Intraoperative nerve monitoring combined with robot-assisted radical prostatectomy (RP) plays a key role in protecting the cavernous nerves and improving postoperative erectile function (EF) recovery.

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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