Erectile function recovery rate after radical prostatectomy: a meta-analysis.

Area of Science:

• Urology
• Oncology
• Reproductive Medicine

Background:

• Erectile function recovery (EFR) rates after radical prostatectomy (RP) exhibit significant variability.
• Factors influencing EFR include erectile dysfunction (ED) definition, data collection methods, and patient demographics.

Purpose of the Study:

• To perform a meta-analysis of selected studies to determine the overall EFR rate following RP.
• To identify factors associated with varying EFR rates post-RP.

Main Methods:

• A comprehensive literature search was conducted using EMBASE and MEDLINE (1985-2007).
• Studies were rigorously assessed for inclusion criteria: reported EFR data post-RP, >50 patients, >1 year follow-up, declared nerve-sparing status, no pre-surgery ED, and no other prostate cancer therapies.
• Meta-analysis was employed to calculate the overall EFR rate and relative risks for specific subgroups.

Main Results:

• Only 22 out of 212 identified studies met the inclusion criteria, analyzing data from 9,965 RPs (4,983 with EFR data).
• The overall EFR rate was 58%.
• Single-center studies reported higher EFR (60%) than multicenter studies (33%). Robot-assisted RP showed higher EFR (73%) compared to open or laparoscopic RP. Patients under 60 had higher EFR (77%) than older patients (61%).

Conclusions:

• A significant portion of published literature does not meet stringent criteria for reporting post-RP EFR.
• Single-center studies demonstrate higher EFR rates compared to multicenter studies.
• Younger age is associated with improved EFR, and no significant difference in EFR was observed between open and laparoscopic RP.