FACTORS PREDICTING RECOVERY OF ERECTIONS AFTER RADICAL PROSTATECTOMY
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- 1 December 2000
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Urology
- Vol. 164 (6), 1929-1934
- https://doi.org/10.1016/s0022-5347(05)66921-2
Abstract
Because preservation of functioning penile erections is a major concern for many patients considering treatment for localized prostate cancer, we analyzed various factors determined before and after radical retropubic prostatectomy to identify those significantly associated with recovery of erectile function. Our prospective database of patients undergoing pelvic lymphadenectomy and radical retropubic prostatectomy was used to determine factors predictive of erection recovery after radical prostatectomy. The study included 314 consecutive men with prostate cancer treated with radical retropubic prostatectomy between November 1993 and December 1996. Preoperative potency satisfactory for intercourse and degree of neurovascular bundle preservation during the operation were documented. Patient age, preoperative potency status and extent of neurovascular bundle preservation but not pathological stage were predictive of potency recovery after radical prostatectomy. At 3 years after the operation 76% of men younger than age 60 years with full erections preoperatively who had bilateral neurovascular bundle preservation would be expected to regain erections sufficient for intercourse. Compared to the younger men, those 60 to 65 years old were only 56% (95% confidence interval [CI] 37 to 84) and those older than 65 years were 47% (95% CI 30 to 73) as likely to recover potency. Patients with recently diminished erections were only 63% (95% CI 38 to 100) as likely to recover potency as men with full erections preoperatively, and those with partial erections were only 47% (95% CI 23 to 96) as likely to recover potency. Resection of 1 neurovascular bundle reduced the chance of recovery to 25% (95% CI 10 to 61) compared to preserving both nerves. Knowledge of preoperative erectile function and patient age before the operation and the degree of neurovascular bundle preservation afterward may aid in patient counseling regarding potency recovery after radical prostatectomy.Keywords
This publication has 13 references indexed in Scilit:
- POTENCY, CONTINENCE AND COMPLICATION RATES IN 1,870 CONSECUTIVE RADICAL RETROPUBIC PROSTATECTOMIESJournal of Urology, 1999
- POTENCY AND CONTINENCE FOLLOWING ANATOMIC RADICAL PROSTATECTOMYJournal of Urology, 1999
- TRENDS IN POORLY DIFFERENTIATED PROSTATE CANCER 1973 to 1994: OBSERVATIONS FROM THE SURVEILLANCE, EPIDEMIOLOGY AND END RESULTS DATABASEJournal of Urology, 1998
- Patient-Reported Impotence and Incontinence After Nerve-Sparing Radical ProstatectomyJNCI Journal of the National Cancer Institute, 1997
- Trends in treatment of localized prostate cancer by radical prostatectomy: Observations from the Commission on Cancer National Cancer Database, 1985–1990Urology, 1994
- Return of Erections and Urinary Continence Following Nerve Sparing Radical Retropubic ProstatectomyJournal of Urology, 1993
- Sexual Function following Radical Prostatectomy: Influence of Preservation of Neurovascular BundlesJournal of Urology, 1991
- Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. Analysis and examplesBritish Journal of Cancer, 1977
- Partial likelihoodBiometrika, 1975
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958