Factors affecting erectile function after radical retropubic prostatectomy: Results from 1620 consecutive patients

Rajinikanth Ayyathurai, Murugesan Manoharan, Alan M. Nieder, Bruce Kava, Mark S. Soloway

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

OBJECTIVE: To report the return of erectile function in 1620 consecutive men after radical retropubic prostatectomy (RRP), chosen by half of men diagnosed with clinically localized prostate cancer, and the goal of which is to completely excise the tumour while preserving continence and erectile function. PATIENTS AND METHODS: From January 1992 to October 2006, one surgeon performed RRP with a nerve-sparing technique where feasible. Men with erectile dysfunction before surgery, salvage RRPs, those not having a nerve-sparing procedure, neoadjuvant or adjuvant therapy within 6 months of RRP and a follow-up of <6 months were excluded from the analyses. Erectile function was evaluated by the surgeon when possible or by an annual questionnaire. Potency was defined as erectile function sufficient for intercourse with or without a phosphodiesterase-5 inhibitor. RESULTS: Of 619 men who had a bilateral and of 178 who had a unilateral nerve-sparing RRP, 72% and 53%, respectively, were potent. When stratifying by age groups (≤49, 50-59, 60-69 and ≥70 years) potency rates were 86%, 76%, 58% and 37%, respectively. Potency was more common after bilateral than unilateral nerve-sparing RRP in all age groups (P < 0.001). Age, bilateral nerve-sparing (odds ratio 2.9) and surgeon experience were associated with potency in a multivariate analysis. CONCLUSION: Careful patient selection and meticulous surgical technique are essential to achieve the right balance between cancer control and morbidity. The patient's age, nerve-sparing RRP and the surgeon's experience were the significant predictors of return of potency after RRP.

Original languageEnglish
Pages (from-to)833-836
Number of pages4
JournalBJU International
Volume101
Issue number7
DOIs
StatePublished - Apr 1 2008

Fingerprint

Prostatectomy
Age Groups
Phosphodiesterase 5 Inhibitors
Erectile Dysfunction
Patient Selection
Neoplasms
Prostatic Neoplasms
Multivariate Analysis
Odds Ratio
Morbidity
Surgeons

Keywords

  • Nerve-sparing surgery
  • Potency
  • Radical prostatectomy

ASJC Scopus subject areas

  • Urology

Cite this

Factors affecting erectile function after radical retropubic prostatectomy : Results from 1620 consecutive patients. / Ayyathurai, Rajinikanth; Manoharan, Murugesan; Nieder, Alan M.; Kava, Bruce; Soloway, Mark S.

In: BJU International, Vol. 101, No. 7, 01.04.2008, p. 833-836.

Research output: Contribution to journalArticle

Ayyathurai, Rajinikanth ; Manoharan, Murugesan ; Nieder, Alan M. ; Kava, Bruce ; Soloway, Mark S. / Factors affecting erectile function after radical retropubic prostatectomy : Results from 1620 consecutive patients. In: BJU International. 2008 ; Vol. 101, No. 7. pp. 833-836.
@article{3df44897ce78492a8ddf2c0185fdd534,
title = "Factors affecting erectile function after radical retropubic prostatectomy: Results from 1620 consecutive patients",
abstract = "OBJECTIVE: To report the return of erectile function in 1620 consecutive men after radical retropubic prostatectomy (RRP), chosen by half of men diagnosed with clinically localized prostate cancer, and the goal of which is to completely excise the tumour while preserving continence and erectile function. PATIENTS AND METHODS: From January 1992 to October 2006, one surgeon performed RRP with a nerve-sparing technique where feasible. Men with erectile dysfunction before surgery, salvage RRPs, those not having a nerve-sparing procedure, neoadjuvant or adjuvant therapy within 6 months of RRP and a follow-up of <6 months were excluded from the analyses. Erectile function was evaluated by the surgeon when possible or by an annual questionnaire. Potency was defined as erectile function sufficient for intercourse with or without a phosphodiesterase-5 inhibitor. RESULTS: Of 619 men who had a bilateral and of 178 who had a unilateral nerve-sparing RRP, 72{\%} and 53{\%}, respectively, were potent. When stratifying by age groups (≤49, 50-59, 60-69 and ≥70 years) potency rates were 86{\%}, 76{\%}, 58{\%} and 37{\%}, respectively. Potency was more common after bilateral than unilateral nerve-sparing RRP in all age groups (P < 0.001). Age, bilateral nerve-sparing (odds ratio 2.9) and surgeon experience were associated with potency in a multivariate analysis. CONCLUSION: Careful patient selection and meticulous surgical technique are essential to achieve the right balance between cancer control and morbidity. The patient's age, nerve-sparing RRP and the surgeon's experience were the significant predictors of return of potency after RRP.",
keywords = "Nerve-sparing surgery, Potency, Radical prostatectomy",
author = "Rajinikanth Ayyathurai and Murugesan Manoharan and Nieder, {Alan M.} and Bruce Kava and Soloway, {Mark S.}",
year = "2008",
month = "4",
day = "1",
doi = "10.1111/j.1464-410X.2007.07409.x",
language = "English",
volume = "101",
pages = "833--836",
journal = "BJU International",
issn = "1464-4096",
publisher = "Wiley-Blackwell",
number = "7",

}

TY - JOUR

T1 - Factors affecting erectile function after radical retropubic prostatectomy

T2 - Results from 1620 consecutive patients

AU - Ayyathurai, Rajinikanth

AU - Manoharan, Murugesan

AU - Nieder, Alan M.

AU - Kava, Bruce

AU - Soloway, Mark S.

PY - 2008/4/1

Y1 - 2008/4/1

N2 - OBJECTIVE: To report the return of erectile function in 1620 consecutive men after radical retropubic prostatectomy (RRP), chosen by half of men diagnosed with clinically localized prostate cancer, and the goal of which is to completely excise the tumour while preserving continence and erectile function. PATIENTS AND METHODS: From January 1992 to October 2006, one surgeon performed RRP with a nerve-sparing technique where feasible. Men with erectile dysfunction before surgery, salvage RRPs, those not having a nerve-sparing procedure, neoadjuvant or adjuvant therapy within 6 months of RRP and a follow-up of <6 months were excluded from the analyses. Erectile function was evaluated by the surgeon when possible or by an annual questionnaire. Potency was defined as erectile function sufficient for intercourse with or without a phosphodiesterase-5 inhibitor. RESULTS: Of 619 men who had a bilateral and of 178 who had a unilateral nerve-sparing RRP, 72% and 53%, respectively, were potent. When stratifying by age groups (≤49, 50-59, 60-69 and ≥70 years) potency rates were 86%, 76%, 58% and 37%, respectively. Potency was more common after bilateral than unilateral nerve-sparing RRP in all age groups (P < 0.001). Age, bilateral nerve-sparing (odds ratio 2.9) and surgeon experience were associated with potency in a multivariate analysis. CONCLUSION: Careful patient selection and meticulous surgical technique are essential to achieve the right balance between cancer control and morbidity. The patient's age, nerve-sparing RRP and the surgeon's experience were the significant predictors of return of potency after RRP.

AB - OBJECTIVE: To report the return of erectile function in 1620 consecutive men after radical retropubic prostatectomy (RRP), chosen by half of men diagnosed with clinically localized prostate cancer, and the goal of which is to completely excise the tumour while preserving continence and erectile function. PATIENTS AND METHODS: From January 1992 to October 2006, one surgeon performed RRP with a nerve-sparing technique where feasible. Men with erectile dysfunction before surgery, salvage RRPs, those not having a nerve-sparing procedure, neoadjuvant or adjuvant therapy within 6 months of RRP and a follow-up of <6 months were excluded from the analyses. Erectile function was evaluated by the surgeon when possible or by an annual questionnaire. Potency was defined as erectile function sufficient for intercourse with or without a phosphodiesterase-5 inhibitor. RESULTS: Of 619 men who had a bilateral and of 178 who had a unilateral nerve-sparing RRP, 72% and 53%, respectively, were potent. When stratifying by age groups (≤49, 50-59, 60-69 and ≥70 years) potency rates were 86%, 76%, 58% and 37%, respectively. Potency was more common after bilateral than unilateral nerve-sparing RRP in all age groups (P < 0.001). Age, bilateral nerve-sparing (odds ratio 2.9) and surgeon experience were associated with potency in a multivariate analysis. CONCLUSION: Careful patient selection and meticulous surgical technique are essential to achieve the right balance between cancer control and morbidity. The patient's age, nerve-sparing RRP and the surgeon's experience were the significant predictors of return of potency after RRP.

KW - Nerve-sparing surgery

KW - Potency

KW - Radical prostatectomy

UR - http://www.scopus.com/inward/record.url?scp=40449093658&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=40449093658&partnerID=8YFLogxK

U2 - 10.1111/j.1464-410X.2007.07409.x

DO - 10.1111/j.1464-410X.2007.07409.x

M3 - Article

C2 - 18190627

AN - SCOPUS:40449093658

VL - 101

SP - 833

EP - 836

JO - BJU International

JF - BJU International

SN - 1464-4096

IS - 7

ER -