We examined post-prostatectomy orgasmic function (OF) and assessed for potential predictors.
Between 2005 and 2013, 499 men underwent radical prostatectomy and completed quality of life questionnaires prospectively preoperatively and at regular postoperative intervals. We used mixed effects logistic regression models to evaluate average differences in follow-up measures and interactions with time.
At a median follow-up of 36 months, OF was worsened, stable, or improved in 300 (60.1%), 152 (30.5%), and 47 (9.4%) men, respectively. OF recovery plateaued at 15 to 21 months. High postoperative OF was positively associated with younger age (odds ratio (OR) for age≤50 years vs. age 51-60 years=3.40, 95% confidence interval 1.56-7.41), nerve sparing (ORs=7.11, 2.55-19.77; 4.34, 1.38-13.58; 3.93, 1.17-13.16 for bilateral, modified, and unilateral nerve sparing, respectively), erectile function (OR=4.67, 3.32-6.57) and sexual desire (OR=5.51, 3.95-7.68) but negatively associated with lower urinary tract symptoms (OR=0.58, 0.41-0.82) and urinary incontinence (OR=0.38, 0.25-0.56). Although robotic status did not influence OF in the overall cohort, it was associated with faster recovery in a subgroup analysis of 356 patients with long follow-up. In another subgroup analysis of 235 men with long follow-up and poor erectile function, the association of high preoperative OF and bilateral nerve sparing with high OF persisted, suggesting their independent effect on OF apart from that on erectile function.
Orgasmic function recovery after radical prostatectomy is a lengthy process. Predictors of OF include preoperative OF, age, nerve sparing status, erectile function, sexual desire, and urinary control and function.
The Journal of urology. 2017 Mar 18 [Epub ahead of print]
Kefu Du, Chong Zhang, Angela P Presson, Jonathan D Tward, William O Brant, Christopher B Dechet
University of Utah Division of Urology, 30 North 1900 East Room 3b110, Salt Lake City, UT 84132. Electronic address: ., University of Utah Division of Epidemiology, Williams Building 295 Chipeta Way Salt Lake City, UT 84108. Electronic address: ., University of Utah Division of Epidemiology, Williams Building 295 Chipeta Way Salt Lake City, UT 84108. Electronic address: ., University of Utah Department of Radiation Oncology, Huntsman Cancer Hospital 1950 Circle of Hope Salt Lake City, UT 84112. Electronic address: ., University of Utah Division of Urology, 30 North 1900 East Room 3b110, Salt Lake City, UT 84132. Electronic address: ., University of Utah Division of Urology, Huntsman Cancer Hospital, 1950 Circle of Hope, Salt Lake City, UT 84112. Electronic address: .