[Natural and artificial erections in spite of radical, non-nerve-sparing retropubic prostatectomy].
OBJECTIVE
The aim of this study was to evaluate sexual functions (SF) of patients after retropubic, non-nerve-sparing radical prostatectomy (NNS-RP).


METHODS
A self-assessment survey on 213 selected patients (multiple choice questionnaire, 18 questions and 80 choices with regard to pre- and postoperative SF and course of tumor disease) was performed. The analysed parameters were demographics, sexual desire, capacities for erections and intercourses, orgasm, use of potency-supporting drugs and devices, attending physicians, life quality (LQ), and S100 immunohistochemical staining on neurovasculare bundles (NVB).


RESULTS
The general response rate of the survey was 61.5 %. 123 data files were evaluable. 87 % of the patients reported on pre-operative erections (n = 107). Of these 12.1 % (n = 13) noticed residual nocturnal erections after NNS-RP. One patient had additional arbitrary full-erections that enabeled him to practice intercourse (< 50 % of attempts sufficient). Bilateral resections of NVB were confirmed on all histopathological specimens from erectile patients. Although 59.2 % of the patients reported on sexual desires (71/120) that persisted postoperatively, only 53.3 % (38/71) tested drugs or devices to induce or improve erections. 18 of these 38 patients (47.4 %) were finally capable of intercourses. 9 of 123 patients were sildenafil-responders, eight of them without any spontaneous erections. 23.8 % of the patients reported on a severe decrease in quality of life due to complete or partial loss of SF. However, only 62.6 % patients (77/123) asked for professional support regarding SF. For this purpose 88.3 % (68/77) consulted an urologist.


CONCLUSIONS
The existence of residual spontaneous erectile activities and responses on sildenafil after NNS-RP indicate some kind of functional accessory routes for innervations besides the NVB (or submaximal resections). However, the prevalence and quality of the observed erections were clinically insignificant.
Hahn
C
C
Urologische Klinik, Klinikum Darmstadt, Germany.
Haussen
R Heyny-von
RH
Löhr
M
M
Patsialas
Ch
Ch
Rohde
D
D
D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D003075:Coitus; D003625:Data Collection; D007172:Erectile Dysfunction / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D010879:Piperazines / Q000627:therapeutic use; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000601:surgery; D011687:Purines / Q000627:therapeutic use; D011788:Quality of Life; D012189:Retrospective Studies; D019529:Sexuality; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D014665:Vasodilator Agents / Q000627:therapeutic use
D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate