To evaluate the frequency of sexual intercourse and sexual activity of patients after undergoing nerve sparing (NS) robot-assisted laparoscopic radical prostatectomy (RARP).
We prospectively obtained two-years longitudinal Expanded Prostate Cancer Index Composite (EPIC) and Sexual Health Inventory for Men (SHIM) score data from 99 patients. We classified the frequency of sexual intercourse and sexual activity as "none", "less than once a week", "about once a week", "several times a week", and "daily".
The percentages of patients who took part in sexual activity before undergoing NS RARP and 3, 6, 9, 12, 18, and 24 months after NS RARP were 55.6, 27.9, 38.8, 42.5, 44.4, 41.7, and 42.1%, respectively. Those of patients who took part in sexual intercourse before undergoing RARP and 3, 6, 9, and 12, 18, and 24 months after RARP were 40.4, 9.0, 13.3, 16.3, 16.7, 22.2, and 23.7%, respectively. Preoperative sexual status was classified into two groups: those who had undergone sexual intercourse or those who only had undergone sexual activity except sexual intercourse. Sexual function was investigated longitudinally using EPIC and SHIM data between the two groups. The SHIM reflected improvement of sexual function in the sexual intercourse group but did not do so in the sexual activity except sexual intercourse group. On the other hand, sexual function in the EPIC might reflect the postoperative improvement of sexual function in the sexual activity except sexual intercourse group.
There was a large discrepancy between the percentages of patients taking part in sexual intercourse and sexual activity; therefore, surveys on postoperative sexual function are recommended to include not only sexual intercourse but also sexual activity.
BJU international. 2020 Dec 04 [Epub ahead of print]
Shogo Inoue, Testutaro Hayashi, Jun Teishima, Akio Matsubara
Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan.