Title:Molecular Pathophysiology of Cavernous Nerve Injury and Identification of Strategies for Nerve Function Recovery After Radical Prostatectomy
Volume: 16
Issue: 5
Author(s): Emmanuel Weyne, John Mulhall and Maarten Albersen
Affiliation:
关键词:
海绵体神经损伤，勃起功能障碍，免疫调节，神经移植，神经生长因子，神经调节，PDE5抑制剂，根治性前列腺切除术
摘要: Despite nerve-sparing techniques, erectile dysfunction remains commonly observed after
radical prostatectomy due to neuropraxia to the cavernous nerves during surgery. Preservation and rehabilitation
of erectile function after radical prostatectomy remains challenging and many men stay
undertreated with the current armory of therapies available in clinical practice. In this article we provide
a comprehensive overview of the pathophysiology of the nerve injury occurring during radical
prostatectomy and describe different strategies aimed at enhancing neuroprotection and regeneration of
the cavernous nerves in order to improve erectile function recovery. These strategies include immunomodulatory,
neurotrophic, growth factor and stem cell therapy have convincingly shown improved erectile function and
recovery in rat animal models after cavernous nerve injury. Furthermore we describe the rationale for penile rehabilitation
with PDE5i out of a neuronal recovery point of view. Many of these strategies reviewed have the potential to optimize
erectile function recovery after radical prostatectomy when translated from pre-clinical models to clinical practice.
