Factors predicting recovery of erections after radical prostatectomy Journal Article


Authors: Rabbani, F.; Stapleton, A. M. F.; Kattan, M. W.; Wheeler, T. M.; Scardino, P. T.
Article Title: Factors predicting recovery of erections after radical prostatectomy
Abstract: Purpose: Because preservation of functioning penile erections is a major concern for many patients considering treatment for localized prostate cancer, we analyzed various factors determined before and after radical retropubic prostatectomy to identify those significantly associated with recovery of erectile function. Materials and Methods: Our prospective database of patients undergoing pelvic lymphadenectomy and radical retropubic prostatectomy was used to determine factors predictive of erection recovery after radical prostatectomy. The study included 314 consecutive men with prostate cancer treated with radical retropubic prostatectomy between November 1993 and December 1996. Preoperative potency satisfactory for intercourse and degree of neurovascular bundle preservation during the operation were documented. Results: Patient age, preoperative potency status and extent of neurovascular bundle preservation but not pathological stage were predictive of potency recovery after radical prostatectomy. At 3 years after the operation 76% of men younger than age 60 years with full erections preoperatively who had bilateral neurovascular bundle preservation would be expected to regain erections sufficient for intercourse. Compared to the younger men, those 60 to 65 years old were only 56% (95% confidence interval [CI] 37 to 84) and those older than 65 years were 47% (95% CI 30 to 73) as likely to recover potency. Patients with recently diminished erections were only 63% (95% CI 38 to 100) as likely to recover potency as men with full erections preoperatively, and those with partial erections were only 47% (95% CI 23 to 96) as likely to recover potency. Resection of 1 neurovascular bundle reduced the chance of recovery to 25% (95% CI 10 to 61) compared to preserving both nerves. Conclusions: Knowledge of preoperative erectile function and patient age before the operation and the degree of neurovascular bundle preservation afterward may aid in patient counseling regarding potency recovery after radical prostatectomy.
Keywords: adult; aged; middle aged; patient satisfaction; recovery of function; major clinical study; follow-up studies; prospective studies; proportional hazards models; pelvis lymphadenectomy; risk factors; risk factor; age; prostate cancer; prostatic neoplasms; probability; prostatectomy; erectile dysfunction; patient counseling; penile erection; sexual intercourse; impotence; roc curve; penis erection; nerve; humans; human; male; priority journal; article
Journal Title: Journal of Urology
Volume: 164
Issue: 6
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2000-12-01
Start Page: 1929
End Page: 1934
Language: English
PUBMED: 11061884
PROVIDER: scopus
DOI: 10.1016/S0022-5347(05)66921-2
DOI/URL:
Notes: Export Date: 18 November 2015 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Peter T Scardino
    671 Scardino
  2. Farhang Rabbani
    84 Rabbani
  3. Michael W Kattan
    218 Kattan