Men with low preoperative sexual function may benefit from nerve sparing radical prostatectomy

Catherine R. Harris, Sanoj Punnen, Peter R. Carroll

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Purpose: We determined the effect of nerve sparing radical prostatectomy on sexual and urinary function in men at various levels of pretreatment sexual function. Materials and Methods: Men in the CaPSURE™ (Cancer of the Prostate Strategic Urologic Research Endeavor) database who underwent radical prostatectomy and had baseline and 2-year posttreatment UCLA-PCI sexual function and urinary function scores were selected. Nerve sparing was categorized as bilateral, unilateral or none and the level of pretreatment sexual function was divided into quartiles. The cohort was divided into subgroups of nerve sparing technique and pretreatment sexual function. Differences between sexual function and urinary function among subgroups were determined. A test of interaction was performed between preoperative sexual function and degree of nerve sparing on postoperative sexual function and urinary function scores. Results: A total of 1,322 patients met the study inclusion criteria. Median patient age was 61 years (range 41 to 79). Bilateral, unilateral and no nerve sparing procedures were performed in 899, 200 and 223 men, respectively. The effects of nerve sparing on sexual function differed among the quartiles of preoperative sexual function (p <0.01). Nerve sparing did not have an effect on the sexual function of men in the lowest quartile of preoperative sexual function score (p = 0.15) but did have a significant beneficial effect on sexual function in the higher 3 quartiles (p = 0.04, p <0.01 and p <0.01, respectively). Alternatively, nerve sparing improved urinary function in men in the lowest quartile of baseline sexual function. Conclusions: Nerve sparing radical prostatectomy results in better sexual function outcomes than no nerve sparing in most men except those with little baseline function. Urinary function was positively impacted in all men. Men who are suitable candidates for nerve preservation may benefit from nerve sparing surgery. Poorer baseline sexual function should not exclude these men from such surgery.

Original languageEnglish (US)
Pages (from-to)981-986
Number of pages6
JournalJournal of Urology
Volume190
Issue number3
DOIs
StatePublished - Sep 2013
Externally publishedYes

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Prostatectomy
Prostatic Neoplasms
Databases
Research

Keywords

  • erectile dysfunction
  • physiological
  • prostatectomy
  • prostatic neoplasms
  • sexual dysfunction
  • urinary incontinence

ASJC Scopus subject areas

  • Urology

Cite this

Men with low preoperative sexual function may benefit from nerve sparing radical prostatectomy. / Harris, Catherine R.; Punnen, Sanoj; Carroll, Peter R.

In: Journal of Urology, Vol. 190, No. 3, 09.2013, p. 981-986.

Research output: Contribution to journalArticle

Harris, Catherine R. ; Punnen, Sanoj ; Carroll, Peter R. / Men with low preoperative sexual function may benefit from nerve sparing radical prostatectomy. In: Journal of Urology. 2013 ; Vol. 190, No. 3. pp. 981-986.
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abstract = "Purpose: We determined the effect of nerve sparing radical prostatectomy on sexual and urinary function in men at various levels of pretreatment sexual function. Materials and Methods: Men in the CaPSURE™ (Cancer of the Prostate Strategic Urologic Research Endeavor) database who underwent radical prostatectomy and had baseline and 2-year posttreatment UCLA-PCI sexual function and urinary function scores were selected. Nerve sparing was categorized as bilateral, unilateral or none and the level of pretreatment sexual function was divided into quartiles. The cohort was divided into subgroups of nerve sparing technique and pretreatment sexual function. Differences between sexual function and urinary function among subgroups were determined. A test of interaction was performed between preoperative sexual function and degree of nerve sparing on postoperative sexual function and urinary function scores. Results: A total of 1,322 patients met the study inclusion criteria. Median patient age was 61 years (range 41 to 79). Bilateral, unilateral and no nerve sparing procedures were performed in 899, 200 and 223 men, respectively. The effects of nerve sparing on sexual function differed among the quartiles of preoperative sexual function (p <0.01). Nerve sparing did not have an effect on the sexual function of men in the lowest quartile of preoperative sexual function score (p = 0.15) but did have a significant beneficial effect on sexual function in the higher 3 quartiles (p = 0.04, p <0.01 and p <0.01, respectively). Alternatively, nerve sparing improved urinary function in men in the lowest quartile of baseline sexual function. Conclusions: Nerve sparing radical prostatectomy results in better sexual function outcomes than no nerve sparing in most men except those with little baseline function. Urinary function was positively impacted in all men. Men who are suitable candidates for nerve preservation may benefit from nerve sparing surgery. Poorer baseline sexual function should not exclude these men from such surgery.",
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