ANALYSIS OF THE CAUSES OF SEXUAL DISORDERS IN PATIENTS WITH PROSTATE CANCER AFTER SURGICAL AND COMPLEX TREATMENT

Abstract

Objective: Analysis of the causes of sexual disorders in patients with prostate cancer after combination therapy. Material and Methods: 30 patients with prostate cancer were examined after 1-2 years of antitumor treatment including radical prostatectomy and/or radiation and glandular therapy. The comparative group consisted of 15 healthy men. Immuneenzyme analysis was used for detection of sexual hormone status; ultrasound and dopplergraphic methods as well as radiation method were conducted for angiographic study of pool vessels of the inner pudendal artery. Denervation disturbances in the pool of the inner sexual artery were diagnosed by the conduction of the applicative electroneuromyographic studies of the penis. Results: According to research conducted in 100% of cases within patients with prostate cancer erectile and sexual dysfunction were detected after combination therapy, which was not detected before therapy. Sporadic usage of the Vth type of phosphodiesterase inhibitors by patients with erectile dysfunction of severe form did not lead to improvement of potency. The main cause of erectile and sexual dysfunction in patients with prostate cancer was an aggressive antitumor therapy, which led to the development of stenosis in 100% of cases, occlusion in the pool of internal pudendal artery and in 100% cases to sensory-motor disorders of innervation of the penis. Maximum androgen blockade aggravated sexual dysfunctions within the patients with prostate cancer. Conclusion: Denervation and hemodynamically significant perfusion disturbances in the pool of the inner pudendal artery within the patients with prostate cancer after surgical and combination therapy lead to erectile and sexual dysfunction. The only possible mean of sexual rehabilitation of patients with prostate cancer after antitumor treatment is the endoprosthesis of penis.