背景:盆腔癌引起的变化之一是患者性功能下降,影响他们在治疗期间和治疗后的生活质量(QoL)。性功能障碍(SD)与严重的射精功能障碍有关,性不满,性欲和性欲降低,性高潮的强度降低,勃起困难,性频率较低。
目的:本系统评价研究保守治疗(非手术和非药物治疗)对男性盆腔癌的疗效。
方法:在Cochrane图书馆进行了系统搜索,PubMed,CINAHL,PEDro,Embase,和2023年9月的VHL数据库,使用与人口相关的MeSH术语,研究设计,干预,和结果。
结果:由于缺乏其他治疗方法的研究,仅包括前列腺癌研究。研究使用盆底肌肉训练(8项研究);生物反馈(1项研究);阴茎振动器(1项研究);电刺激(2项研究);冲击波疗法(2项研究);有氧,阻力,和灵活性练习(2项研究);和真空勃起装置(1项研究)。所有文章都评估了干预组的性功能并报告了改善情况,包括5个,组间没有差异。涉及冲击波疗法的文章描述了SD的改善,但与临床无关。评估QoL的研究报告了实验组的益处。报告了真空勃起装置和阴茎振动器的不利影响。
结论:保守治疗在治疗男性前列腺癌患者的SD方面比其他治疗更有效。需要进一步的研究来评估这些治疗的有害影响。在这项研究中,我们发现有证据表明,此类治疗可改善该人群的性功能和QoL.
BACKGROUND: One of the changes caused by pelvic cancers is the decrease in patients\' sexual function, which influences their quality of life (QoL) during and after treatment. Sexual dysfunction (SD) is associated with severe ejaculatory dysfunction, sexual dissatisfaction, reduced libido and sexual desire, decreased intensity of orgasm, difficulty in erection, and lower sexual frequency.
OBJECTIVE: This systematic review investigated the effectiveness of conservative treatments (nonsurgical and nonpharmacologic) for SD in males with pelvic cancer.
METHODS: Systematic searches were performed in the Cochrane Library, PubMed, CINAHL, PEDro, Embase, and VHL databases in September 2023 by using MeSH terms related to population, study design, intervention, and outcome.
RESULTS: Only prostate cancer studies were included due to a lack of studies in other treatments. Studies used pelvic floor muscle training (8 studies); biofeedback (1 study); a penile vibrator (1 study); electrostimulation (2 studies); shock wave therapy (2 studies); aerobic, resistance, and flexibility exercises (2 studies); and a vacuum erection device (1 study). All articles assessed sexual function and reported improvements in the intervention group, including 5 with no differences between the groups. Articles involving shock wave therapy described improvements in SD but were not clinically relevant. Studies evaluating QoL reported benefits in the experimental groups. Adverse effects of a vacuum erection device and penile vibrator were reported.
CONCLUSIONS: Conservative treatments are more effective than others in treating SD in men with prostate cancer. Further studies are needed to assess the unwanted effects of these treatments. In this study, we found evidence that this type of therapy improves sexual function and QoL in this population.