This study aims to determine the effects of radical retropubic prostatectomy on post-operative erectile function.
A total of 50 patients were included in this study, diagnosed with localized prostate cancer, and underwent nerve-sparing radical retropubic prostatectomy. All patients completed the International Index of Erectile Function (IIEF-5) questionnaire pre-operatively and on the third, sixth, and twelfth post-operative month and completed a self-reporting of their satisfaction with their sexual performance. Patients with a history of severe heart disease, were on erectile dysfunction medication, or had a score of 7 or less on the IIEF-5 questionnaire, were excluded from the study.
Pre-operatively it was observed that the lower the IIEF-5 score, the higher the biopsy Gleason score. Post-operatively, 16 patients stated that erectile function had returned to the pre-operative IIEF-5 category. In contrast, only 13 of them stated they were happy with their sexual performance on the self-reporting scale. The rest reported dissatisfaction despite returning to their pre-operative erectile function status. IIEF-5 scores were also different when compared amongst the four age groups, with scores indicating that younger age is related to higher IIEF-5 scores. At the 3-month follow-up, no statistically significant difference was observed between age groups. Finally, patients younger than 64 reported significantly less deterioration in post-operative erectile function.
Post-radical prostatectomy erectile dysfunction remains one of the most pressing issues in prostate cancer therapy. A higher Gleason score has a more significant impact on pre-operative ED, and at the same time, the best post-operative ED results are observed in younger patients. Finally, patients need extensive follow-up, therapy, and pre-and post-operative psychological support to have the best possible erectile function.
Cureus. 2023 Feb 03*** epublish ***
Konstantinos Pikramenos, Maria Zachou, Dimitrios Papadopoulos, Athanasios Papatsoris, Ioannis Varkarakis, Iraklis Mitsogiannis
Second Department of Urology, National and Kapodistrian University of Athens, Sismanoglio General Hospital, Athens, GRC., Gastroenterology, National and Kapodistrian University of Athens, Athens, GRC., Anaesthesiology, Evgenidio Hospital, National and Kapodistrian University of Athens, Athens, GRC.