Local steroid application during nerve-sparing radical retropubic prostatectomy.
OBJECTIVE
To evaluate the effect on potency rates after surgery of applying local steroids to the neurovascular bundles (NVBs) of the prostate after bilateral nerve-sparing radical retropubic prostatectomy (BNS-RRP).


METHODS
Sixty potent men undergoing BNS-RRP for clinically localized prostate cancer were prospectively randomized equally into two groups. In group 1, 10 mL of betamethasone cream 0.1% was applied locally to both NVBs, and group 2 had only the usual BNS-RRP with no corticoid cream. Complications and potency were evaluated at 3, 6 and 12 months in all patients and compared between the groups.


RESULTS
At 12 months, 57% and 60% of patients were potent in group 1 and 2, respectively; the respective mean International Index of Erectile Function (5-item) scores were 14.76 and 15.43 (P = 0.59). Potency rates at 3, 6 and 12 months were not significantly different between the groups, and the continence rates at 12 months were also similar, with 93% and 90% of patients in groups 1 and 2 being continent, respectively. Ten and five patients in groups 1 and 2, respectively, required a blood transfusion (P = 0.23). There were no fistulae, wound dehiscence or rectal perforations. One patient in group 2 presented 4 months after RRP with a bladder neck contracture.


CONCLUSIONS
Local application of betamethasone does not improve or expedite the recovery of erectile function after BNS-RRP, but there were no complications associated with its use.
Deliveliotis
Charalambos
C
2nd Department of Urology, University of Athens, Greece.
Delis
Athanasios
A
Papatsoris
Athanasios
A
Antoniou
Nikos
N
Varkarakis
Ioannis M
IM
D001623:Betamethasone / Q000008:administration & dosage* / Q000627:therapeutic use; D016009:Chi-Square Distribution; D007172:Erectile Dysfunction / Q000517:prevention & control; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D014549:Urinary Incontinence / Q000517:prevention & control
D005938:Glucocorticoids; D001623:Betamethasone