SUMMARY

Aim: To develop a management strategy (rehabilitation programme) for postsurgi-cal erectile dysfunction (ED) among men experiencing ED associated with treat-ment of prostate, bladder or rectal cancer that is suitable for use in a UK NHS healthcare context. Methods: PubMed literature searches of ED management together with a survey of 13 experts in the management of ED from across the UK were conducted. Results: Data from 37 articles and completed questionnaires were collated. The results discussed in this study demonstrate improved objective and subjective clinical outcomes for physical parameters, sexual satisfaction, and rates of both spontaneous erections and those associated with ED treatment strat-egies. Conclusion: Based on the literature and survey analysis, recommendations are proposed for the standardisation of management strategies employed for post-surgical ED. What’s known Following surgery for prostate, bladder or rectal cancers, loss of erections and cavernous tissue damage may result in significant reductions in penile length and circumference, and these changes have been shown to occur within the first few months of surgery. However, with the introduction of nerve-sparing (NS) surgery, erectile function (EF) can be preserved in a significant proportion of patients. Unfortunately, even with NS techniques, ED can still be a long-term and sometimes permanent complication for many patients What’s new Currently, there are no UK-wide recommendations for postsurgical ED management strategies following treatment for prostate, bladder or rectal cancer. This study provides a brief overview of current strategies for postsurgical ED management and preservation of erectile function, based on a worldwide literature search. Literature review data are combined with recommendations from an expert panel – individuals who have used various strategies in their clinical practice – to propose evidence-based recommendations for standardised ED management that can be implemented effectively throughout the UK