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* To whom correspondence should be addressed. E-mail: ekim{at}mc.utmck.edu.
Penile 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 post-operatively resulted in improvements in the return of spontaneous erectile function led to the development of penile rehabilitation protocols. Chronic dosing of PDE-V 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 post-prostatectomy patient. This article reviews the current evidence behind penile rehabilitation therapy.
Key words: Erectile Dysfunction •
Penis •
Prostate •
Penile rehabilitation •
Radical prostatectomy •
Vasoactive therapy
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