Canadian consensus algorithm for erectile rehabilitation following prostate cancer treatment

  • Dean S. Elterman Division of Urology, University Health Network, Toronto, ON
  • Anika R. Petrella Division of Urology, University Health Network, Toronto, ON
  • Lauren M. Walker Department of Oncology, University of Calgary, Calgary, AB
  • Brandon Van Asseldonk Division of Urology, University Health Network, Toronto, ON
  • Leah Jamnicky Division of Urology, University Health Network, Toronto, ON
  • Gerald B. Brock Department of Surgery, St. Joseph’s Hospital, London, ON
  • Stacy Elliott Department of Psychiatry, University of British Columbia, Vancouver, BC
  • Antonio Finelli Division of Urology, University Health Network, Toronto, ON
  • Jerzy B. Gajewski Department of Urology, Dalhousie University, Halifax, NS
  • Keith A. Jarvi Murray Koffler Urologic Wellness Centre, Mount Sinai Hospital, Toronto, ON
  • John Robinson Clinical Psychology Department, University of Calgary, Calgary, AB
  • Janet Ellis Department of Psychology, Sunnybrook Health Sciences Centre, Toronto, ON
  • Shaun Shepherd Division of Urology, University Health Network, Toronto, ON
  • Hossein Saadat Division of Urology, University Health Network, Toronto, ON
  • Andrew Matthew
Keywords: men's health, prostate cancer, erectile rehabilitation

Abstract

Introduction: The present descriptive analysis carried out by a pan-Canadian panel of expert healthcare practitioners (HCPs) summarizes best practices for erectile rehabilitation following prostate cancer (PCa) treatment. This algorithm was designed to support an online sexual health and rehabilitation e-clinic (SHARe- Clinic), which provides biomedical guidance and supportive care to Canadian men recovering from PCa treatment. The implications of the algorithm may be used to inform clinical practice in community settings.

Methods: Men’s sexual health experts convened for the TrueNTH Sexual Health and Rehabilitation Initiative Consensus Meeting to address concerns regarding erectile dysfunction (ED) therapy and management following treatment for PCa. The meeting brought together experts from across Canada for a discussion of current practices, latest evidence-based literature review, and patient interviews.

Results: An algorithm for ED treatment following PCa treatment is presented that accounts for treatment received (surgery or radiation), degree of nerve-sparing, and level of pro-erectile treatment invasiveness based on patient and partner values. This algorithm provides an approach from both a biomedical and psychosocial focus that is tailored to the patient/partner presentation. Regular sexual activity is recommended, and the importance of partner involvement in the treatment decision-making process is highlighted, including the management of partner sexual concerns.

Conclusions: The algorithm proposed by expert consensus considers important factors like the type of PCa treatment, the timeline of erectile recovery, and patient values, with the goal of becoming a nationwide standard for erectile rehabilitation following PCa treatment.

Published
2018-12-03
How to Cite
Elterman, D. S., Petrella, A. R., Walker, L. M., Asseldonk, B. V., Jamnicky, L., Brock, G. B., Elliott, S., Finelli, A., Gajewski, J. B., Jarvi, K. A., Robinson, J., Ellis, J., Shepherd, S., Saadat, H., & Matthew, A. (2018). Canadian consensus algorithm for erectile rehabilitation following prostate cancer treatment. Canadian Urological Association Journal, 13(8). https://doi.org/10.5489/cuaj.5653
Section
Consensus Statement