Postoperative orgasmic function increases over time in patients undergoing nerve-sparing radical prostatectomy.
BACKGROUND
Postprostatectomy orgasmic function (OF) remains poorly defined.


OBJECTIVE
To assess OF over time in patients who underwent bilateral nerve-sparing radical retropubic prostatectomy (BNSRRP) for organ-confined prostate cancer (PCa).


METHODS
Baseline data were obtained from 334 consecutive preoperatively sexually active PCa patients at hospital admission; data included a medical and sexual history, IIEF domain scores, and ICIQ-SF. Questionnaire were then completed every 12 months postoperatively, and patients participated in a semistructured interview at the 12-month (191/334 [57.2%] patients), 24-month (95/334 [28.4%] patients), 36-month (42/334 [12.6%] patients), and 48-month (19/334 [5.7%] patients) follow-up (FU).


METHODS
IIEF-OF domain values throughout the FU. Multivariate linear regression analysis (MVA) of the association between predictors (patient's age, IIEF-erectile function [EF], ICIQ-SF, and the use of postoperative proerectile pharmacological treatments) and the IIEF-OF at 12-month, 24-month, and 36-month FU.


RESULTS
Preoperative mean (median) IIEF-OF was 7.6 (10). The anova analysis showed an increase of the IIEF-OF values (P = 0.008; F = 4.009) throughout the FU (namely, IIEF-OF 12-month: 6.1 [6]; 24-month: 7.2 [8]; 36-month: 7.3 [8]; and 48-month: 7.7 [9.50]). The 12-month MVA showed that while proerectile oral therapy did not affect postoperative OF (P = 0.150; Beta 0.081), IIEF-OF linearly increased with IIEF-EF (P < 0.001; Beta 0.425). Conversely, IIEF-OF linearly decreased with patient's age (P < 0.001; Beta -0.135) and with ICQ-SF scores (P < 0.001; Beta -0.438). The 24-month and 36-month analyses showed that IIEF-OF still linearly increased with IIEF-EF (P < 0.001; Beta 0.540, and P < 0.001; Beta 0.536 respectively at the 24- and 36-month FU), whereas pharmacological therapy, rate of urinary continence, and patient's age did not significantly affect postoperative OF.


CONCLUSIONS
Postoperative OF significantly ameliorates over time in patients undergoing BNSRRP. The higher the postoperative EF score, the higher the OF throughout the FU time frame.
Vita-Salute San Raffaele, Department of Urology, University, Milan, Italy.
Andrew
A
Salonia
Andrea
A
Gallina
Alberto
A
Briganti
Renzo
R
Colombo
Roberto
R
Bertini
Luigi F
LF
Da Pozzo
Giuseppe
G
Zanni
Antonio
A
Sacca
Lorenzo
L
Rocchini
Giorgio
G
Guazzoni
Patrizio
P
Rigatti
Francesco
F
Montorsi
D000368:Aged; D007172:Erectile Dysfunction / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D011379:Prognosis; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D011788:Quality of Life / Q000523:psychology; D020018:Sexual Dysfunctions, Psychological / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires