Erectile function recovery in patients after non-nerve sparing radical prostatectomy

Area of Science:

• Urology
• Oncology
• Sexual Medicine

Background:

• Radical prostatectomy (RP) for prostate cancer can impact erectile function.
• Limited data exists on erectile function recovery (EFR) rates after non-nerve sparing resections during RP.
• Existing studies show high variability in EFR, hindering patient counseling.

Purpose of the Study:

• To investigate EFR rates and predictors at 24 months post-RP in patients with unilateral cavernous nerve resection (UNR) and bilateral cavernous nerve resection (BNR).

Main Methods:

• Population-based prospective cohort study of 966 RP patients (2008-2012).
• Cavernous nerve status classified using a 4-point nerve sparing score into bilateral sparing, UNR, and BNR groups.
• Erectile function (EF) assessed pre-RP and 24-30 months post-op using a validated patient-reported scale; EFR defined as post-op EF grade 1-2.

Main Results:

• Mean baseline EF was 1.84±1.3 for UNR and 2.74±1.5 for BNR patients.
• EFR was achieved by 33% of UNR patients and 13% of BNR patients.
• Age and baseline EF were predictors of EFR. Baseline EF significantly predicted EFR at 24 months for UNR patients; for BNR patients, pre-RP EF was the sole predictor.

Conclusions:

• Patients undergoing nerve resection during RP have a significant chance of achieving EFR.
• UNR surgery demonstrates greater potential for EFR compared to BNR surgery.
• Age and baseline EF are crucial factors for predicting EFR outcomes in UNR and BNR patients, aiding in patient counseling.