[Evaluation of sexuality and erectile function of candidates for radical prostatectomy].
OBJECTIVE
To evaluate sexuality and erectile function of candidates for radical prostatectomy in order to assess the place of nerve-sparing surgery in the preoperative discussion.


METHODS
From June 2004 to January 2005, 75 consecutive patients, candidates for radical prostatectomy, were prospectively evaluated. Their erectile function and sexuality were evaluated after announcing the diagnosis. Patients completed the IIEF (International Index of Erectile Function), EQS (Erection Quality Scale) and the sexual satisfaction score (SSS). The mean age of the patients was 65 years and 50% were younger than 65.


RESULTS
Erectile dysfunction according to the IIEF-5 scale was observed in 64% of cases (43% of patients younger than 65 and 84% of patients over 65). Erectile dysfunction was considered to be severe in 5% of young patients versus 34% of patients over 65. The majority of patients (69%) had a sexual activity more than twice a month. Only 31% of patients under 65 and 8% of older patients considered their erections to be very satisfactory according to the EQS. Despite this high frequency of erectile dysfunction in men over the age of 65, sexual satisfaction was not influenced by erectile dysfunction. In contrast, patients younger than 65, erectile dysfunction clearly altered the SST sexual satisfaction score.


CONCLUSIONS
Erectile dysfunction was present in a large proportion of candidates for radical prostatectomy. The presence of erectile dysfunction in patients over the age of 65 did not modify their sexual satisfaction score. A detailed clinical interview concerning sexuality should be conducted to select patients likely to benefit from nerve-sparing surgery. Nerve-sparing surgery would be beneficial in young patients in whom sexual satisfaction is dependent on erectile function. In the older men, erectile dysfunction can be present without affecting sexual satisfaction.
Long
Jean-Alexandre
JA
Service d'Urologie, Hôpital Foch, Suresnes, France. j.long@libertysurf.fr
Lebret
Thierry
T
Saporta
François
F
Hervé
Jean-Marie
JM
Lugagne
Pierre-Marie
PM
Poulain
Jean-Eudes
JE
Yonneau
Laurent
L
Loison
Guillaume
G
Orsoni
Jean-Luc
JL
Botto
Henry
H
D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D011300:Preoperative Care; D011446:Prospective Studies; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000503:physiopathology* / Q000601:surgery*; D019529:Sexuality; D011795:Surveys and Questionnaires