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FACTORS PREDICTING RECOVERY OF ERECTIONS AFTER RADICAL PROSTATECTOMY

2000; Lippincott Williams & Wilkins; Volume: 164; Issue: 6 Linguagem: Inglês

10.1016/s0022-5347(05)66921-2

1527-3792

Farhang Rabbani, Alan M. F. Stapleton, Michael W. Kattan, Thomas M. Wheeler, Peter T. Scardino,

Male Reproductive Health Studies

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Dec 2000FACTORS PREDICTING RECOVERY OF ERECTIONS AFTER RADICAL PROSTATECTOMY FARHANG RABBANI, ALAN M.F. STAPLETON, MICHAEL W. KATTAN, THOMAS M. WHEELER, and PETER T. SCARDINO FARHANG RABBANIFARHANG RABBANI More articles by this author , ALAN M.F. STAPLETONALAN M.F. STAPLETON More articles by this author , MICHAEL W. KATTANMICHAEL W. KATTAN More articles by this author , THOMAS M. WHEELERTHOMAS M. WHEELER More articles by this author , and PETER T. SCARDINOPETER T. SCARDINO More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)66921-2AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail 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. References 1 : Sexual function following radical prostatectomy: influence of preservation of neurovascular bundles. J Urol1991; 145: 998. Link, Google Scholar 2 : Return of erections and urinary continence following nerve sparing radical retropubic prostatectomy. J Urol1993; 150: 905. Link, Google Scholar 3 : Nerve sparing radical prostatectomy: a different view. J Urol1995; 154: 145. Link, Google Scholar 4 : Anatomic radical retropubic prostatectomy. In: . Edited by . Philadelphia: W. B. Saunders Company1998: 2565. chapt. 86. Google Scholar 5 : Radical prostatectomy for clinical stage T1 and T2 prostate cancer. 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Volume 164Issue 6December 2000Page: 1929-1934 Advertisement Copyright & Permissions© 2000 by American Urological Association, Inc.Keywordspenile erectionprostatic neoplasmsprostatectomyrisk factorsimpotenceMetricsAuthor Information FARHANG RABBANI More articles by this author ALAN M.F. STAPLETON More articles by this author MICHAEL W. KATTAN More articles by this author THOMAS M. WHEELER More articles by this author PETER T. SCARDINO More articles by this author Expand All Advertisement PDF downloadLoading ...