Erectile dysfunction after prostatectomy: an evaluation of the risk factors

The occurrence of erectile dysfunction (ED) in patients who have undergone prostatectomy has been assessed in the previous studies; however, its rate and risk factors vary in different studies. This study was conducted to assess the possible risk factors for ED after prostatectomy.

In total, 246 men with benign prostatic hyperplasia (BPH) who were candidates for either open prostatectomy or transurethral resection of the prostate (TURP) were admitted in this study during a period of 3 years between December 2000 and December 2003. Cardiac risk index was assessed before the operation using American Heart Association guidelines and erectile function was assessed both preoperatively and 6 months after surgery. Patients with moderate to severe ED according to the five-item version of the International Index of Erectile Function were considered as ED afflicted. In this study, the prevalence of preoperative ED, the incidence of postoperative ED, and those conditions that could lead to an increase in the incidence of postoperative ED in either procedure were determined.

The mean age of the patients was 63.7+/-9.7 years. The prevalence rates of preoperative ED were 24.6% and 25.9% in TURP and open prostatectomy groups, respectively. Among patients with no or mild ED preoperatively, 12.5% showed moderate to severe ED postoperatively (13.4% in TURP group vs 11.25% in open prostatectomy group).

The incidence rate of postoperative ED after prostatectomy was 12.5%. Risk factors for its appearance included hypertension, diabetes mellitus, higher transfusion rates, higher cardiac risk index and an older age.