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Urinary continence and erectile function: a prospective evaluation of functional results after radical laparoscopic
Laurent Salomon1, Aristotelis G Anastasiadis, Ran Katz
1Department of Urology, Henri Mondor Hospital, S1 av du Mal-de-Lattre-de-Tasslgny, 94010 Créteil, France. aa910@columbia.edu
Objectives:
To evaluate prospectively functional results (urinary continence and erectile function) after laparoscopic radical prostatectomy.
Methods:
From 1998 to 2001, 235 patients underwent laparoscopic radical prostatectomy for localized prostate cancer. All of them completed a confidential, self-administered questionnaire regarding urinary continence and erectile function before, and 1, 3, 6, and 12 months after surgery. Results were analyzed separately for day and night for urinary continence and status of neurovascular bundles as well as age for erectile function.
Results:
To date, 100 consecutive patients have completed all questionnaires. Diurnal and nocturnal urinary continence have increased to 90% and 97% one year after surgery. Overall, 49.3% of the 77 patients, who were potent preoperatively, and did not receive any form of adjuvant therapy, had erections sufficient for intercourse one year after surgery. Potency rates were 38.4%, 53.8% and 58.8% after no, unilateral, and bilateral nerve bundle preservation, respectively. For younger patients (<60 years) with unilateral and bilateral neurovascular bundle preservation, potency rates were 75% and 83.3%, respectively.
Conclusion:
One year after laparoscopic radical prostatectomy, urinary continence rate is 90% during the day and 97% during the night. Overall potency rates after bilateral preservation of neurovascular bundles are 58.8% and 83.8% for the subgroup of younger patients (<60 years).