Early postoperative pelvic-floor biofeedback improves erectile function in men undergoing radical prostatectomy: a...

Area of Science:

• Urology
• Sexual Medicine
• Rehabilitation

Background:

• Radical prostatectomy (RP) frequently leads to erectile dysfunction (ED) and urinary incontinence.
• The efficacy of pelvic-floor biofeedback training (PFBT) for improving erectile function (EF) post-RP remains unclear.
• Urinary continence is a known complication, but its impact on potency recovery is not fully understood.

Purpose of the Study:

• To prospectively evaluate the impact of PFBT on erectile function (EF) recovery in patients undergoing RP.
• To compare EF recovery rates between patients receiving PFBT and those in a control group.
• To investigate the association between urinary continence and potency recovery after RP.

Main Methods:

• Fifty-two patients undergoing RP were randomized into a PFBT group (3 months of weekly sessions and home exercises) or a control group (verbal instructions).
• Erectile function was assessed using the International Index of Erectile Function-5 (IIEF-5) pre-surgery and at 1, 3, 6, and 12 months post-surgery.
• Continence was defined as no pad usage; potency was defined as an IIEF-5 score >20.

Main Results:

• The PFBT group showed significantly higher potency recovery rates at 12 months (47.1%) compared to the control group (12.5%) (P=0.032).
• A strong association was observed between urinary continence and potency recovery, with continent patients being 5.4 times more likely to be potent (P=0.04).
• Both groups experienced a reduction in IIEF-5 scores post-surgery, but PFBT mitigated this decline.

Conclusions:

• Early PFBT demonstrates a significant positive impact on the recovery of erectile function following radical prostatectomy.
• Achieving urinary continence post-RP is a strong indicator for successful erectile function recovery.
• PFBT is a promising intervention for improving sexual health outcomes after RP.