Supportive care: Edited by Jean KlasterskyCurrent management of erectile dysfunction after cancer treatmentPeltier, Alexandrea; van Velthoven, Rolanda; Roumeguère, Thierryb Author Information aDepartment of Urology, Institut Jules Bordet, Belgium bErasme Hospital, ULB, University Clinics of Brussels, Brussels, Belgium Correspondence to Alexandre Peltier, MD, Institut Jules Bordet, Avenue Héger Bordet 1, 1000 Bruxelles, Belgium Tel: +32 2 541 31 74; fax: +32 2 541 31 75; e-mail: [email protected] Current Opinion in Oncology: July 2009 - Volume 21 - Issue 4 - p 303-309 doi: 10.1097/CCO.0b013e32832b9d76 Buy Metrics Abstract Purpose of review Erectile dysfunction has a major impact on quality of life. Treating sexual dysfunction after cancer treatment requires special concern because of specific medical, psychological and social factors. This article presents the relevant experimental and clinical recent literature on rehabilitation of erectile function after surgery, external beam radiotherapy, brachytherapy or hormonal deprivation therapy for prostate cancer as it is the most studied model for erectile dysfunction management. Recent findings Counseling and reeducation with a multidisciplinary approach seems to be both mandatory and effective in achieving erectile function recovery. Administration of proerectile drugs nightly or on-demand early after cancer treatment is probably the key factor of erectile rehabilitation. Several studies have highlighted the presumption of a potential role for phosphodiesterase type 5 inhibitors (PDE5-Is) in the prevention of endothelial damage related to ischemia-reperfusion and denervation following surgery or pelvic radiation. Larger multicancer, randomized, controlled trials are needed to assess the role of PDE5-Is in erectile dysfunction pharmacological prophylaxis and rehabilitation strategy. Summary Erectile dysfunction postcancer treatment requires multimodal management with early administration of PDE5-Is, combined therapy to maintain erectile tissue oxygenation if necessary with PDE5-Is, intracavernosal injection and transurethral alprostadil or even vacuum erect device, psychological counseling considering erectile dysfunction as a couple's issue. The best modality to optimize postcancer erectile dysfunction management has not yet been standardized and is still challenging. © 2009 Lippincott Williams & Wilkins, Inc.