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Prostate Cancer

In the United States, prostate cancer is the most common type of cancer among men. Approximately 268,490 newly diagnosed prostate cancer cases and 34,500 prostate cancer-related deaths were estimated in the United States in 2022. In South Korea, prostate cancer was documented to be the most common cancer among men for the first time in 2022, with approximately 22,391 newly diagnosed prostate cancer cases and 2,278 prostate cancer-related deaths.

The Goal of Radical Prostatectomy

The goal of radical prostatectomy is to secure oncologic outcomes (free from cancer recurrence) as well as functional outcomes, which include restoration of urinary continence and erectile function. Despite remarkable advances in radical prostatectomy techniques such as nerve-sparing procedures and the widespread application of robotic surgical systems, postoperative potency rates have been reported to vary significantly. For instance, 1- or 2-year potency rates have been reported between 54–90% or 63–94%, respectively. Furthermore, despite treatment with phosphodiesterase type-5 inhibitors, less than 50% of patients return to their preoperative baseline erectile function.

Emerging Therapies for Erectile Dysfunction

Low-intensity shock wave therapy is an emerging therapeutic technique aimed at maximizing erectile function recovery after radical prostatectomy. In a pilot study conducted in 2016 by Frey et al., involving 16 patients who underwent bilateral nerve-sparing radical prostatectomy more than 12 months prior, it was found that low-intensity shock wave therapy could improve erectile function. The study reported a median improvement in International Index of Erectile Function-5 scores of 3.5 at one month and 1 at twelve months after therapy.

Recent Trials on Low-Intensity Shock Wave Therapy

In 2022, a prospective trial was conducted comparing the efficacy of early low-intensity shock wave therapy combined with daily tadalafil therapy against tadalafil-only therapy for postprostatectomy erectile dysfunction. From April 2019 to March 2021, 165 patients were enrolled in this study, with 80 completing it successfully. The results indicated that early low-intensity shock wave therapy combined with tadalafil was more effective than tadalafil alone in improving erectile function.

Contradictory Findings on Radial Wave Therapy

An interesting study published by Bryk et al. investigated whether radial wave therapy could improve early erectile function recovery after nerve-sparing radical prostatectomy. This study found no significant difference in erectile function recovery between the radial wave therapy group and the control group; however, the intervention arm demonstrated higher median Erection Hardness scores.

What’s The Next Step?

At Pelvic Health Physical Therapy, our certified physical therapists will provide you with a thorough evaluation to determine what the best treatment plan will be for you. We understand how inhibiting pain and stiffness can be, and we want to help get you back to comfortably living your life. We’ll help lift all of your physical stresses away!

Please email receptionmadison@pelvichealthnj.com to book an appointment, or call our office at 908-443-9880.

 

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