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Erectile function after non-nerve-sparing radical prostatectomy: fact or fiction?
Holger Borchers1, Bernhard Brehmer, Ruth Kirschner-Hermanns
1Urological Clinic, University Clinic Aachen, Rheinisch-Westfalisch Technical University, Aachen, Germany.
Urologia Internationalis
|April 8, 2006
Summary
Radical prostatectomy with wide neurovascular bundle excision significantly impacts erectile function. Few patients achieve spontaneous erections sufficient for intercourse one year post-surgery.
Area of Science:
- Urology
- Sexual Medicine
Background:
- Radical prostatectomy is a common treatment for prostate cancer.
- Preservation of erectile function is a key concern for patients undergoing prostatectomy.
- Wide excision of neurovascular bundles during surgery may affect postoperative potency.
Purpose of the Study:
- To evaluate the impact of radical perineal prostatectomy with wide neurovascular bundle excision on erectile function.
- To assess the rate of spontaneous erections sufficient for sexual intercourse post-surgery.
Main Methods:
- Prospective study involving 128 patients.
- Quality-of-life questionnaires assessing sexual function administered preoperatively and at 6 and 12 months postoperatively.
- A subset of patients with reported erectile function received a detailed follow-up questionnaire.
Main Results:
- Preoperatively, 57.8% of patients reported erections sufficient for intercourse.
- One year postoperatively, only 8.1% of these patients experienced spontaneous erections (1-5 times/week).
- Detailed questionnaires revealed these spontaneous erections were insufficient for satisfactory sexual intercourse.
Conclusions:
- Standardized radical prostatectomy with wide neurovascular bundle excision is associated with a very low likelihood of achieving spontaneous erections sufficient for intercourse.
- The surgical approach significantly compromises postoperative erectile function.