Purpose: The recovery of potency following radical prostatectomy is complex and has a very wide range.
In this study we analyzed in detail the precise pattern of recovery of potency following robot-assisted radical prostatectomy (RARP).
Materials and Methods: Prospectively collected database of patients with a minimum follow-up of 1 year after RARP were evaluated retrospectively. Of 503 patients identified, 483 patients completed the SHIM pre-operatively and post-operatively every 3 months for the first 12 months. Overall potency, usage of PDE-5 inhibitors, and return to baseline erectile function were evaluated. Potency was defined as having erection that is sufficient for sexual intercourse more than 50% of attempts while quality potency was defined as being potent without the use of PDE-5 inhibitors.
Results: Pre-operatively, the overall potency and quality potency rate were 67.1 and 48.1%, respectively. Post-operatively, the overall potency rate was 61.4% while the quality potency rate was 37.2%. In multivariate regression analysis, independent predictors of potency recovery were young age (< 60), preoperative potency status, and bilateral preservation of neurovascular bundles (NVBs). In men with SHIM > 21, the overall potency and quality potency rate were 79.7% and 41.2%, respectively. More importantly, only 21.4% of the men with normal erection preoperatively (SHIM > 21) returned to baseline erectile function (SHIM > 21) 12 months after surgery.
Conclusions: This study indicates that young age (< 60), preoperative potency, and bilateral preservation of NVBs were positive predictors of potency recovery following RARP. However, overwhelming majority of men experience a deterioration in the overall quality of erection after RARP.
Written by:
Woo SH, Kang DI, Ha YS, Salmasi AH, Kim JH, Lee DH, Kim WJ, Kim IY. Are you the author?
The Cancer Institute of New Jersey, Urologic Oncology, 195 Little Albany, New Brunswick, New Jersey, United States; Eulji Universty, Urology, dunsan-2-dong, Seogu, Daejeon, Daejeon, Korea, Republic of.
Reference: J Endourol. 2013 Aug 30. Epub ahead of print.
doi: 10.1089/end.2013.0304
PubMed Abstract
PMID: 23987521
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