urovestВестник урологииUrology Herald2308-6424Rostov State Medical University10.21886/2308-6424-2024-12-6-45-51urovest-979Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWS ARTICLEСексуальная дисфункция после низкодозной брахитерапии рака предстательной железыSexual dysfunction following low-dose-rate brachytherapy for prostate cancerhttps://orcid.org/0009-0002-2126-3136АносовА. Д.AnosovA. D.

Анатолий Дмитриевич Аносов

Краснодар

Anatoly D. Anosov

Krasnodar

vester.orient@gmail.comhttps://orcid.org/0000-0003-2733-0619ЕфремовМ. Е.EfremovM. E.

Михаил Евгеньевич Ефремов, канд. мед. наук

Краснодар

Mikhail E. Efremov, Сand.Sc.(Med)

Krasnodar

efremov.uro@yandex.ruhttps://orcid.org/0000-0001-8335-2578МедведевВ. Л.MedvedevV. L.

Владимир Леонидович Медведев, д-р мед. наук, профессор

Краснодар

Vladimir L. Medvedev,  Dr.Sc. (Med.), Full Prof.

Krasnodar

medvedev_vl@mail.ruhttps://orcid.org/0000-0002-1710-0169КоганМ. И.KoganM. I.

Михаил Иосифович Коган, д-р мед. наук, профессор, заслуженный деятель науки РФ

Ростов-на-Дону

Mikhail I. Kogan, Dr.Sc.(Med), Full Prof., Hons. Sci. of the Russian Federation

Rostov-on-Don

dept_kogan@mail.ruКубанский государственный медицинский университет; Научно-исследовательский институт – Краевая клиническая больница № 1 им. проф. С.В. ОчаповскогоРоссияKuban State Medical University; Research Institute — Ochapovsky Krasnodar Regional Clinical Hospital No.1Russian FederationРостовский государственный медицинский университетРоссияRostov State Medical UniversityRussian Federation2024070120251264551Copyright © Аносов А.Д., Ефремов М.Е., Медведев В.Л., Коган М.И., 20252025Аносов А.Д., Ефремов М.Е., Медведев В.Л., Коган М.И.Anosov A.D., Efremov M.E., Medvedev V.L., Kogan M.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.urovest.ru/jour/article/view/979

   Рак предстательной железы (РПЖ) — одна из наиболее часто встречающихся в мире злокачественных опухолей в структуре онкологической заболеваемости (2-e место) и смертности (6-e место) среди мужского населения. Низкодозная брахитерапия (НДБТ) — метод лечения РПЖ, заключающийся в имплантации постоянных радиоактивных источников в ткань предстательной железы. При этом используются изотопы I-125 (чаще всего) и Pd-103. НДБТ приводит к высоким показателям биохимической и клинической безрецидивной выживаемости, обладает эквивалентными с радикальной простатэктомией уровнями канцероспецифической и общей выживаемости. Несмотря на преимущества НДБТ, накоплены данные об осложнениях данного способа лечения РПЖ, в том числе и нарушении сексуальной функции, включая проблемы с эрекцией. Сохранение удовлетворённости от сексуальных отношений является важной проблемой большинства мужчин, сталкивающихся с лечением РПЖ. Но не только эректильная функция должна быть во главе угла у пациента и доктора, необходимо обращать внимание на сохранение сексуальности в целом.

   Целью обзора являлись оценка накопленного материала по теме диагностики и лечения сексуальных дисфункций после НДБТ.

   Проведён анализ статей зарубежных и отечественных авторов за период с 2014 по 2024 год, а также датированных в более раннее время фундаментальных статей и литературы, посвящённых сексуальной дисфункции, оценке и реабилитации сексуальной функции у пациентов с РПЖ, подвергшихся НДБТ. Наш обзор подтвердил имеющуюся необходимость в детальном изучении рациональных способов диагностики сексуальных дисфункций до выбора метода лечения, а также возможного предотвращения нарушений после НДБТ. Также необходимо разработать сексуальную и пенильную реабилитацию после НДБТ РПЖ, которая в настоящее время имеет широкое применение.

   Prostate cancer (PCa) is one of the most prevalent forms of male malignancies globally, ranking second in terms of incidence and sixth in terms of mortality. Low-dose-rate brachytherapy (LDRT) represents a treatment modality for PCa, involving the implantation of permanent radioactive sources into the prostate tissue. The isotopes predominantly utilised are I–125 and Pd–103. LDRT demonstrates high rates of biochemical and clinical relapse-free survival, with cancer-specific and overall survival rates comparable to those achieved through radical prostatectomy. Despite the advantages associated with LDRT, evidence has accumulated regarding the potential complications accompanying this treatment approach, including sexual dysfunction and erectile dysfunction. Sexual satisfaction constitutes a critical concern for men undergoing PCa treatment. It is essential that both the patient and the healthcare provider prioritise not only erectile function but also the preservation of sexuality in its entirety.

   The present study endeavours to evaluate the accumulated material on the topic of diagnosing and treating sexual dysfunctions following low-dose-rate brachytherapy (LDRT).

   The analysis encompassed articles by foreign and domestic authors published between 2014 and 2024, as well as fundamental articles and literature dating back earlier. These works were devoted to sexual dysfunction, assessment, and rehabilitation of sexual function in patients with PCa who underwent LDRT. Our review confirmed the existing necessity for a detailed study of rational methods for diagnosing sexual dysfunctions prior to selecting a treatment method, as well as the possible prevention of disorders after LDRT. It is also essential to develop sexual and penile rehabilitation strategies following LDRT for PCa, which is currently widely employed.

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The authors declare that there are no conflicts of interest present.