Korean J Urol.  2007 Mar;48(3):283-290. 10.4111/kju.2007.48.3.283.

Predictive Factor to Regain Erectile Function after Bilateral Nerve Sparing Radical Retropubic Prostatectomy in Korean Men

• Chang IH
• Han JH
• Yu JH
• Han BK
• Jeong SJ
• Hong SK
• Byun SS
• Lee SE

• KMID: 1997126
• DOI: http://doi.org/10.4111/kju.2007.48.3.283

Abstract

PURPOSE
To investigate the significance of various preoperative factors with regard to postoperative erectile function in Korean men undergoing a bilateral nerve sparing radical retropubic prostatectomy (BNSRRP), using the validated Korean version of the International Index of Erectile Function (IIEF-5).
MATERIALS AND METHODS
Between March 2004 and March 2005, 83 consecutive patients, who underwent a BNSRRP, with preoperative IIEF-5 scores greater than 13, were retrospectively analyzed. All patients were asked to answer the IIEF-5 questionnaire during the preoperative period and 1 year postoperatively. The responses were stratified on the basis of the clinical characteristics and the preoperative predictive factors for regaining a normal erectile function (NEF: IIEF-5 score> or =18) investigated.
RESULTS
At the baseline, 56 patients (67.5%) had NEF. At the 1 year follow-up after the BNSRRP, 58 (70.5%) patients reported a return of a sufficient erection for sexual intercourse, with or without oral phosphodiesterase type 5 (PDE5) inhibitors, but 37 (44.6%) patients regained a NEF. Of these 37 patients, 15 (40.5%) were able to spontaneously regain a NEF, but 22 (59.5%) needed the help of oral PDE5 inhibitors. When the patients were divided according to postoperative NEF and erectile dysfunction (ED: 14< or =IIEF-5 score<18), the preoperative IIEF-5 score was the only significant factor for predicting postoperative NEF after a BNSRRP in univariate (p=0.018) and multivariate analyses [p=0.030, odds ratio: 3.482, 95% confidence interval (CI): 1.125-10.774]. Changes in the IIEF-5 score after a BNSRRP significantly decreased for those with preoperative NEF compared with ED ( 6.1+/-5.24 vs. 9.1+/-7.34, p=0.039).
CONCLUSIONS
Our data indicated that preoperative erectile function, as assessed using the IIEF-5 questionnaire, was an independent variable for predicting the recovery of erectile function after a BNSRRP when performed in Korean men.

Keyword

Prostate cancer; Prostatectomy; Erectile dysfunction

MeSH Terms

Coitus
Erectile Dysfunction
Follow-Up Studies
Humans
Male
Multivariate Analysis
Odds Ratio
Phosphodiesterase 5 Inhibitors
Preoperative Period
Prostatectomy*
Prostatic Neoplasms
Questionnaires
Retrospective Studies
Phosphodiesterase 5 Inhibitors

Figure

• 

  Fig. 1 Proportion regaining erections sufficient for sexual intercourse from patient interviews in relation to the follow-up duration after a bilateral nerve sparing radical retropubic prostatectomy shows that the proportion increased from 25.3% at 3 months to 70.5% after 1 year. The proportion regaining a normal erectile function according to the IIEF-5 score was 44.6%; there were no significant differences in the proportions at the 1 year follow up between the patient interviews and IIEF-5 scores (p<0.05). The graph shows the proportion of patients (%), with the 95% error bar. *: p<0.05. IIEF-5: Korean version of the International Index of Erectile Function-5.

• 

  Fig. 2 Changes in the IIEF-5 score after a bilateral nerve sparing radical retropubic prostatectomy shows a significant decrease in the IIEF-5 score from the preoperative IIEF-5 score (A), which was not age dependent (B). *: p<0.05. IIEF-5: Korean version of the International Index of Erectile Function-5.

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