Table 2 Aids to sexual recovery after post-prostatectomy radiation therapy (currently researched)
From: Counseling patients about sexual health when considering post-prostatectomy radiation treatment
Pharmacological | Physical | Psycho-sexual |
|---|---|---|
Penile rehabilitation options (pretreatment) | Penile rehabilitation (pretreatment) | Education (pretreatment) |
Low-dose prostaglandin E intracavernosal injections (5–10 mcg) or transurethral suppositories (125–250 mcg) periodically for 1 month or | Kegel exercises (3 sets of 10) daily | Psychoeducation about the effect of prostate cancer treatment on sexual functioning |
Low-dose phosphodiesterase 5 inhibitors (1/2 tab every other day) for 1 month | Physical therapy for pelvic floor rehabilitation | Psychoeducation about the typical emotional responses that men and partners experience in the aftermath of prostate cancer treatment (grief and mourning of old sexuality) |
Penile rehabilitation options (posttreatment) | Penile rehabilitation (posttreatment) | Interventions (posttreatment) |
Low-dose prostaglandin E intracavernosal injections (5–10 mcg) or transurethral suppositories (125–250 mcg) every other day for 6 months or | Kegel exercises (3 sets of 10) daily | Comprehensive psychosexual assessment for the individual and couple |
Low-dose phosphodiesterase 5 inhibitors (1/2 dose every other day) for 6 months | Physical therapy for pelvic floor rehabilitation | Psychoeducation about sexual recovery for the man and for the couple: sexual changes, feelings about them, need for experimentation as a part of developing new sexual relationship |
Testosterone replacement | Vacuum erectile devices (thrice a week) for 6 months | Sex therapy when couple has concerns about resuming sexual relationship |
Self-stimulation/masturbation (daily) for 6 months | Individual psychotherapy when man or partner is having difficulty adapting to new sexuality | |
Options of aids to erections | Options of aids to erections | Couple therapy when sexual issues are embedded in long-term couple difficulties |
Prostaglandin E intracavernosal injections (5–20 mcg) or transurethral suppositories (125–1000 mcg) | Vacuum erectile devices | Support groups |
Phosphodiesterase 5 inhibitors | Vasoconstrictive rings | Self-help books on sexuality after cancer treatment |
