Functional recovery after radical prostatectomy for prostate cancer

The assessment of erectile dysfunction after radical prostatectomy using pudendal somatosensory evoked potential

Erectile dysfunction in patients who underwent radical prostatectomy was evaluated with pudendal somatosensory evoked potentials (PSEP) to measure and predict erectile dysfunction objectively. Fifty-seven patients who completed requirements were included in the study. Patients were divided into 2 groups (potency/non-potency). Erectile function recovery was defined as question 2 and 3 on the IIEF-5 questionnaire at 12 months after surgery. The two-channel PSEP test was performed at the day before RP and 3-6 months after RP. Twenty patients were assigned to the potency group and 37 to the non-potency group. Mean age was less in the potency group. Other clinical variables were similar in two groups. The non-potency group had prolonged lumbar and cortical latencies in postoperative PSEP, and the mean differences of latencies between pre- and postoperative PSEP in lumbar and cortical regions were also greater in the non-potency group. Logistic regression analysis showed that age, lumbar post-operative latency, cortical post-operative latency, and difference of latency in lumbar region were associated with non-potency; odds ratios were 1.292 (p = 0.018), 0.425 (p = 0.047), 1.637 (p < 0.001), and 3.272 (p = 0.010), respectively. This study suggests that PSEP is an effective means of evaluating erectile dysfunction in prostate cancer patients after surgery.

Specific nursing improves postoperative urine control function and the self-efficacy of patients undergoing radical prostatectomies

BACKGROUND

Radical prostatectomy is a treatment for prostate cancer (PC), but most patients suffer urinary incontinence, decreased urinary control function, and poor prognoses after the surgery. Specific nursing intervention is a nursing model based on the patients' individual conditions and disease progression.

OBJECTIVE

To investigate the effects of specific nursing intervention on the urinary control functions and self-efficacy of radical prostatectomy patients.

METHODS

From April 1, 2016 to June 30, 2019, 149 patients who underwent radical prostatectomies in our hospital were retrospectively selected for this observational study and assigned to two groups in accordance with the different nursing intervention method each patient underwent. Seventy-six patients who underwent specific nursing intervention were included in the observation group (OG), and 73 patients who underwent routine nursing intervention were included in the control group (CG). The clinical symptoms, the urodynamic indexes, the recoveries of urinary control function, the incidences of urinary incontinence, and the complications were observed in both groups. The Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores were used to evaluate the unhealthy emotions. The self-efficacy scale (GSES) and SF-36 were used to evaluate the self-efficacy and the quality of life (QOL), respectively.

RESULTS

After the nursing, the improvement in the clinical symptoms in the OG was significantly better than it was in CG. The improvement in the postoperative urodynamic indexes in the OG was significantly better than it was in the CG. The recovery of urinary control function in the OG was significantly higher than it was in the CG. The incidence of urinary incontinence in OG was significantly lower than it was in the CG. The incidence of complications in the OG was significantly lower than it was in the CG. The SAS and SDS scores in the OG were significantly lower than they were in the CG. After the intervention, the patients' GSES and SF-36 scores in the OG were significantly higher than they were in the CG.

CONCLUSION

Specific nursing intervention can ameliorate the urinary control functions and self-efficacy, reduce unhealthy emotions, and improve the QOL of radical prostatectomy patients.

Fidgetin-like 2 negatively regulates axonal growth and can be targeted to promote functional nerve regeneration

The microtubule (MT) cytoskeleton plays a critical role in axon growth and guidance. Here, we identify the MT-severing enzyme fidgetin-like 2 (FL2) as a negative regulator of axon regeneration and a therapeutic target for promoting nerve regeneration after injury. Genetic knockout of FL2 in cultured adult dorsal root ganglion neurons resulted in longer axons and attenuated growth cone retraction in response to inhibitory molecules. Given the axonal growth-promoting effects of FL2 depletion in vitro, we tested whether FL2 could be targeted to promote regeneration in a rodent model of cavernous nerve (CN) injury. The CNs are parasympathetic nerves that regulate blood flow to the penis, which are commonly damaged during radical prostatectomy (RP), resulting in erectile dysfunction (ED). Application of FL2-siRNA after CN injury significantly enhanced functional nerve recovery. Remarkably, following bilateral nerve transection, visible and functional nerve regeneration was observed in 7 out of 8 animals treated with FL2-siRNA, while no control-treated animals exhibited regeneration. These studies identify FL2 as a promising therapeutic target for enhancing regeneration after peripheral nerve injury and for mitigating neurogenic ED after RP - a condition for which, at present, only poor treatment options exist.