Erythropoietin promotes erection recovery after nerve-sparing radical retropubic prostatectomy: a retrospective analysis.
BACKGROUND
Erectile dysfunction persists as a major functional complication of nerve-sparing radical prostatectomy.


OBJECTIVE
To evaluate retrospectively the potential benefit of erythropoietin administration to improve erectile function recovery following radical prostatectomy.


METHODS
Preoperatively potent patients who underwent nerve-sparing radical retropubic prostatectomy between March 2005 and February 2006 elected to receive erythropoietin treatment (40,000 IU subcutaneously, single injection on their preoperative day; treatment group, N = 15). A contemporaneous clinically matched cohort comprising patients who elected postoperative standard surveillance only served for comparison (control group, N = 21). Phosphodiesterase type 5 (PDE5) inhibitor "on-demand" use was applied. Potency evaluations were monitored by International Index of Erectile Function-5 questionnaires administered preoperatively and at 3, 6, and 12 months postoperatively.


METHODS
Erection recovery.


RESULTS
Health comorbidities as well as erectile function status were demonstrated to be no different between groups at baseline. Erythropoietin-treated patients demonstrated significantly higher postoperative International Index of Erectile Function-5 questionnaire scores than control group patients at 3, 6, and 12 months postoperatively with or without use of PDE5 inhibitors (P < 0.05). At 12 months postoperatively, the percentages of patients performing sexual activity were 87% and 68% of erythropoietin-treated and control patients, respectively (P = 0.213), although the erythropoietin-treated patients had a significantly greater ability to perform sexual intercourse with minimal or no difficulty (P < 0.05).


CONCLUSIONS
Erythropoietin administration on the preoperative day before undergoing nerve-sparing radical prostatectomy in men reporting normal erectile function preoperatively may confer improved erectile function recovery postoperatively.
Burnett
Arthur L
AL
Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA. aburnett@jhmi.edu
Allaf
Mohamad E
ME
Bivalacqua
Trinity J
TJ
D000222:Adaptation, Physiological; D007172:Erectile Dysfunction / Q000188:drug therapy* / Q000209:etiology*; D004921:Erythropoietin / Q000494:pharmacology / Q000627:therapeutic use*; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D010413:Penis / Q000294:innervation*; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D011994:Recombinant Proteins; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
D011994:Recombinant Proteins; D004921:Erythropoietin