title: Optimal timing to evaluate prediagnostic baseline erectile function in patients undergoing robot-assisted radical prostatectomy.
abstract: BACKGROUND
  Accurate assessment of prediagnostic baseline erectile function (EF) is crucial when evaluating postoperative changes of EF in patients undergoing bilateral nerve sparing robot-assisted laparoscopic radical prostatectomy (RLRP). Because score domains of the International Index of Erectile Function-5 (IIEF-5) can be affected by factors such as recall intervals and psychological stress or discomfort due to cancer diagnosis and treatment, it is important to assess the prediagnostic baseline EF at appropriate times.
  
  
  OBJECTIVE
  To determine optimal timing to evaluate prediagnostic baseline EF in patients undergoing bilateral nerve sparing RLRP.
  
  
  METHODS
  Between March 2009 and February 2010, 54 patients ranging in age from 48 to 74 years were asked to complete IIEF-5 questionnaires before prostate biopsy, 1 day before RLRP, and 1 month after RLRP to assess preoperative baseline EF.
  
  
  METHODS
  Differences in the mean scores of IIEF-5 were analyzed using paired t-tests. The strengths of the linear relationships among the three IIEF-5 scores were quantified using Pearson's correlation coefficient. An interrator agreement analysis in distribution was performed using the kappa statistic to determine the degree of agreement among the IIEF-5 scores.
  
  
  RESULTS
  The mean IIEF-5 score before RLRP was significantly higher than the mean IIEF-5 score before prostate biopsy (P < 0.001). There was no significant difference between the mean IIEF-5 scores before prostate biopsy and 1 month following RLRP (P = 0.931). Scores of the IIEF-5 taken before prostate biopsy and 1 month following RLRP showed substantial agreement (kappa = 0.712), whereas scores of the IIEF-5 taken before prostate biopsy and before RLRP showed lower agreement (kappa = 0.325).
  
  
  CONCLUSIONS
  To more accurately assess the prediagnostic baseline EF in patients with localized prostate cancer, the IIEF-5 questionnaire should be administered before prostate biopsy rather than before RLRP as cancer diagnosis-related symptoms and depression can affect IIEF-5 scores.
authors.affiliation: Department of Urology, Myongji Hospital, Kwandong University College of Medicine, Goyang, Korea.
authors.forename: Dong Suk
authors.initials: DS
authors.lastname: Kim
authors.forename: Yeun Goo
authors.initials: YG
authors.lastname: Chung
authors.forename: Dong Jun
authors.initials: DJ
authors.lastname: Kim
authors.forename: Kyung Kgi
authors.initials: KK
authors.lastname: Park
authors.forename: Mun Su
authors.initials: MS
authors.lastname: Chung
authors.forename: Dae Hoon
authors.initials: DH
authors.lastname: Lee
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Lee
authors.forename: Sang Yol
authors.initials: SY
authors.lastname: Mah
authors.forename: Byung Ha
authors.initials: BH
authors.lastname: Chung
mesh_terms: D000368:Aged; D001706:Biopsy; D007172:Erectile Dysfunction / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000502:physiology*; D011183:Postoperative Complications; D057234:Preoperative Period; D011467:Prostate / Q000473:pathology / Q000601:surgery; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012371:Robotics; D011795:Surveys and Questionnaires