OBJECTIVES: To study the utility of neurovascular preservation for postoperative erection in radical cystectomy.
MATERIALS AND METHODS: Retrospective analysis of 44 cystectomies performed at our center between January 2006-December 2009 in men < 65 years. In 11 cases a neurovascular preservation was done. We analyzed age, BMI, indication for surgery, urinary diversion, use of i-PDE5 or alprostadil, and daytime and nighttime continence. Erection Hardness Score (EHS) was used to assess erectile function.
RESULTS: Spontaneous postoperative erectile function in preservation group was 44,4% EHS 4, 33,3% EHS 3 and 22,3% EHS 1 (achieving EHS 3 or 4 with alprostadil). In the non preservation group, 4,5% achieved EHS 4 spontaneously. The other 95,5% had EHS 0 (4,5% achieved EHS 3 with tadalafil 20mg and 9% with intracavernous injections). Variables age (P= .001) and nerve-sparing surgery (P< .001) were related to postoperative erectile function recovery. In the multivariate analysis, nerve-sparing surgery remained statisticaly significant.
CONCLUSIONS: The functional results in preserving cystectomy are promising. The preservation should be considered in young patients without erectile dysfunction.
Written by:
Vilaseca A, García-Cruz E, Ribal MJ, Pérez Márquez M, Alcaraz A. Are you the author?
Departamento de Urología, Hospital Clínic de Barcelona, Barcelona, España.
Reference: Actas Urol Esp. 2013 Jun 18. pii: S0210-4806(13)00083-1.
doi: 10.1016/j.acuro.2013.02.012
PubMed Abstract
PMID: 23790714
UroToday.com Erectile Dysfunction Section
