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Beratung zur erektilen Dysfunktion während stationärer Rehabilitation nach radikaler Prostatektomie

Counselling for erectile dysfunction during inpatient rehabilitation after radical prostatectomy

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Zusammenfassung

Die erektile Funktion ist für den Mann bezüglich der Lebensqualität und Lebensfreude essentiell. Die postoperative erektile Dysfunktion (ED) nach radikaler Prostatektomie (RPE) stellt neben der Inkontinenz eines der wichtigsten Probleme dar. Als erste Anlaufstation ist die Beratung durch die Rehabilitationsklinik gefordert.

Bei 149 Patienten nach RPE erfolgte eine prospektive Befragung bzgl. des Kenntnisstandes zur postoperativen ED nach RPE und der psychischen Belastung sowie zu den möglichen Therapieoptionen. Die Qualität der präoperativen Patientenaufklärung und der Informationsmodule zur ED während der Rehabilitation wurden bewertet. Eine wesentliche Belastung durch die postoperative ED äußerten 53% der Patienten während der Anschlussrehabilitation (AR-Gruppe) und 70% der Patienten während eines onkologischen Heilverfahrens (Reha-Gruppe). Präoperativ sexuell aktivere Männer litten stärker unter der postoperativen ED. Es bestand in der AR-Gruppe eine negative Korrelation zwischen psychischer Belastung und Lebensalter, die in der Reha-Gruppe nivelliert war. Mit zunehmendem Abstand zur Operation wurde der Leidensdruck bezüglich der ED insbesondere bei den älteren Patienten größer. Die im Rahmen der stationären Rehabilitation durchgeführte Wissensvermittlung zu den Therapieoptionen der ED wurde von 60% der AR-Gruppe und 48% der Reha-Gruppe als wesentlich bewertet.

Therapeutische Möglichkeiten der postoperativen ED nach RPE können dem Patienten in der Vorbereitungsphase zur Operation und während des Aufenthalts in der Akutklinik nicht immer umfassend vermittelt werden. Da jedoch überwiegend ein großer Leidensdruck besteht, eignet sich die stationäre fachspezifische urologische Rehabilitation in besonderer Weise zur umfassenden Beratung des Patienten zur ED nach RPE.

Abstract

For men erectile function is essential for quality of life. Besides urine incontinence postsurgical erectile dysfunction (ED) following radical prostatectomy (RPE) represents a significant and prevalent problem. One of the first approaches to this condition should be a consultation performed by professionals in a rehabilitation clinic.

A total of 149 patients post RPE participated in this prospective study. All patients were questioned about their understanding of postoperative surgical ED after RPE and if affected they were asked about their own psychological burden as well as their knowledge of possible therapy options. The qualities of presurgical patient information as well as the modules of information pertaining to ED during the rehabilitation were evaluated. Of the patients, 53% expressed that they experienced a considerable burden due to postsurgical ED during their follow-up rehabilitation (AR group) and 70% of the patients during oncological rehabilitation treatment (rehab group). Men who were sexually more active prior to surgery suffered more from postsurgical ED than their less active counterparts. A negative correlation between psychological burden and age was found in the AR group, which however was levelled in the rehab group. Particularly in older patients the burden of ED increases with more time elapsing after the operation. The medical information on ED therapy options provided during the inpatient rehabilitation was considered to be essential by 60% of the men in the AR group and 48% of the patients in the rehab group.

Therapeutic possibilities for postsurgical ED following RPE cannot always be given to patients in the preoperative phase or during their stay in the hospital. Since however a large majority of men suffer from postoperative ED following RPE a specialized inpatient urological rehabilitation is suited for a comprehensive consultation.

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Vahlensieck, W., Sommer, F., Mathers, M. et al. Beratung zur erektilen Dysfunktion während stationärer Rehabilitation nach radikaler Prostatektomie. Urologe 50, 417–424 (2011). https://doi.org/10.1007/s00120-010-2476-4

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