title: Orgasmic dysfunction after open radical prostatectomy: clinical correlates and prognostic factors.
abstract: BACKGROUND
  Erectile function after radical retropubic prostatectomy (RRP) is extensively discussed in literature. However, less is known about orgasm after RRP.
  
  
  OBJECTIVE
  To analyze sexual function, in particularly orgasmic function, in men before and after RRP.
  
  
  METHODS
  Between 1977 and 2007 a RRP was performed in 1,021 men. All men were interviewed by their follow-up physician using a standardized interview about sexual function before and after RRP at regular intervals during a 2-year follow-up. The questions were related to sexual interest, sexual activity, spontaneous erections, and orgasmic function.
  
  
  METHODS
  Sexual function, in particularly orgasmic function, before and after RRP. Factors potentially influencing orgasmic function, such as patients age, type of operation, pathological stage and continence status were analyzed for their predictive value. Results. Information about preoperative and postoperative sexual activity and spontaneous erection was available in 596 and 698 men, respectively. Additional questions were asked on sexual interest (N = 425) and orgasmic function (N = 458). Pre-operatively, sexual interest, sexual activity, spontaneous erections and orgasmic function were normal in 99%, 82.1%, 90.0% and 90% of men, respectively. After operation these values decreased to 97.2%, 67.3%, 29.4% and 66.8%, respectively. Orgasmic function was preserved in 141 of 192 men (73.4%) after a bilateral nerve sparing procedure, in 90 out of 127 men (70.9%) after a unilateral nerve-sparing procedure and in 75 of 139 men (54.0%) after non-nerve sparing technique. Postoperatively, orgasm was present in 123 (77.4%) men below the age of 60 years and in 183 (61.2%) men of 60 years and older (P < 0.0001). Orgasmic function was significantly affected by age >or=60 years, non-nerve sparing procedure and severe incontinence (more than two pads/day).
  
  
  CONCLUSIONS
  After RRP, orgasmic function is still present in the majority of men. A non-nerve sparing operation, age, and severe urinary incontinence are risk factors for orgasmic dysfunction after RRP.
authors.affiliation: St Elisabeth Hospital, Urology, Tilburg, The Netherlands. y.dubbelman@elisabeth.nl
authors.forename: Yvette
authors.initials: Y
authors.lastname: Dubbelman
authors.forename: Mark
authors.initials: M
authors.lastname: Wildhagen
authors.forename: Frits
authors.initials: F
authors.lastname: Schröder
authors.forename: Chris
authors.initials: C
authors.lastname: Bangma
authors.forename: Gert
authors.initials: G
authors.lastname: Dohle
mesh_terms: D000368:Aged; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000601:surgery; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology / Q000209:etiology*