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Organo Oficial de la Sociedad Mexicana de Urología

2018, Número 4

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Rev Mex Urol 2018; 78 (4)


Ultrasonido Doppler de pene en la evaluación posterior a prostatectomía radical. Revisión bibliográfica y recomendaciones

Uribe-Arcila JF, Aluma-Sánchez LJ

Idioma: Ingles.
Referencias bibliográficas: 53
Paginas: 335-343
Archivo PDF: 347.52 Kb.


RESUMEN

Los cambios en la función sexual son comunes en pacientes con cáncer de próstata intervenidos de prostatectomía radical. La rehabilitación sexual después de la prostatectomía implica un proceso complejo para establecer el diagnóstico y tratamiento específico. El ultrasonido Doppler de pene es un método común para diagnosticar la disfunción eréctil y útil en ciertos casos después de la cirugía para evaluar el estado de las arterias, tejido cavernoso y la fascia, además de identificar fugas venosas. Se realizó la búsqueda bibliográfica en las bases de datos de Google y PubMed para identificar artículos que examinaron la ecografía Doppler peneana en la evaluación de pacientes intervenidos de prostatectomía radical o rehabilitación posquirúrgica. Términos de búsqueda incluidos: disfunción eréctil posprostatectomía radical, evaluación peneana posprostatectomía, función eréctil después de cirugía radical y rehabilitación sexual. En la búsqueda se obtuvieron 415 artículos. Después de aplicar filtros adicionales se incluyeron 46 estudios. Se citaron los antecedentes de las pautas más relevantes: intervenciones quirúrgicas en medicina sexual, consulta internacional de medicina sexual y estrategias de la EAU y la AUA. La información del ultrasonido Doppler peneano antes de la cirugía es extremadamente inconsistente en la bibliografía. Se incluyeron las recomendaciones para la evaluación exitosa de pacientes con prostatectomía radical. La rehabilitación sexual después de la prostatectomía radical requiere un proceso complejo. Existe inconsistencia en la bibliografía respecto de la definición de la función eréctil normal antes de la cirugía y lo que se considera erección normal después de la prostatectomía radical. El costo del ultrasonido Doppler peneano es un componente modesto del proceso de rehabilitación de la prostatectomía. La evidencia actual no respalda el uso sistemático de la ecografía Doppler peneana, pero debe incluirse en el algoritmo de tratamiento de pacientes intervenidos de cirugía radical de próstata, para que la función eréctil pueda evaluarse adecuadamente.


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