Does diabetes have a negative impact on erectile function recovery after radical prostatectomy? Journal Article


Authors: Flores, J. M.; Thorogood, S.; Jenkins, L. C.; Miyagi, H.; Nelson, C. J.; Benfante, N.; Schofield, E.; Carlsson, S.; Mulhall, J. P.
Article Title: Does diabetes have a negative impact on erectile function recovery after radical prostatectomy?
Abstract: Objective: To quantify the risk of long-term post-radical prostatectomy (RP) erectile dysfunction (ED) in men with diabetes mellitus (DM). Methods: We included men who underwent RP and were followed for ≥24 months at our institution; men were excluded if they received androgen deprivation therapy or radiation therapy. Erectile function recovery (EFR) was assessed using the International Index of Erectile Function (IIEF) Erectile Function Domain (EFD) score pre-RP and serially during follow-up. We performed logistic regression analysis to investigate a potential association between erectile function 24 months post-RP. Results: Of 2261 men included, 8% were diabetic. Men in the diabetic group tended to present with more vascular comorbidities. For men with DM, the median time from diagnosis was 4 years pre-RP, and the median hemoglobin A1c pre-RP was 6.7%. After 24 months post-RP, EFR was significantly lower among the diabetic group. The median EFD was 7. Men with DM had a lower proportion of functional EFR (17%) and a greater proportion of severe ED (57%). In the univariable logistic regression model to analyze DM diagnosis was a significant predictor of functional EFR (OR 0.43, P <.001) and severe ED (OR 1.85, P <.001) 24 months post-RP. Furthermore, this was not observed for a multivariable analysis. Conclusion: Twenty-four months after RP, EFR is compromised in individuals with DM © 2024 Elsevier Inc.
Keywords: adult; aged; middle aged; recovery of function; retrospective studies; major clinical study; hypertension; follow up; hemoglobin; retrospective study; physiology; postoperative complication; postoperative complications; prostatic neoplasms; body mass; training; prostatectomy; prostate tumor; diabetes mellitus; surgery; radical prostatectomy; diabetes complications; epidemiology; logistic regression analysis; erectile dysfunction; convalescence; androgen deprivation therapy; hyperlipidemia; penile erection; penis erection; etiology; international index of erectile function; adverse event; complication; procedures; humans; human; male; female; article; diabetic complication
Journal Title: Urology
Volume: 194
ISSN: 0090-4295
Publisher: Elsevier Science, Inc.  
Date Published: 2024-12-01
Start Page: 327
End Page: 332
Language: English
DOI: 10.1016/j.urology.2024.07.052
PUBMED: 39128637
PROVIDER: scopus
PMCID: PMC11625007
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding MSK author is Jose M. Flores -- Source: Scopus
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MSK Authors
  1. John P Mulhall
    601 Mulhall
  2. Christian Nelson
    391 Nelson
  3. Sigrid Viktoria Carlsson
    220 Carlsson
  4. Nicole E Benfante
    160 Benfante
  5. Elizabeth A Schofield
    161 Schofield