title: Erectile function after cystectomy with neurovascular preservation.
abstract: OBJECTIVE
  To study the utility of neurovascular preservation for postoperative erection in radical cystectomy.
  
  
  METHODS
  Retrospective analysis of 44 cystectomies performed at our center between January 2006-December 2009 in men <65 years. In 11 cases a neurovascular preservation was done. We analyzed age, BMI, indication for surgery, urinary diversion, use of i-PDE5 or alprostadil, and daytime and nighttime continence. Erection Hardness Score (EHS) was used to assess erectile function.
  
  
  RESULTS
  Spontaneous postoperative erectile function in preservation group was 44,4% EHS 4, 33,3% EHS 3 and 22,3% EHS 1 (achieving EHS 3 or 4 with alprostadil). In the non preservation group, 4,5% achieved EHS 4 spontaneously. The other 95,5% had EHS 0 (4,5% achieved EHS 3 with tadalafil 20 mg and 9% with intracavernous injections). Variables age (P=.001) and nerve-sparing surgery (P<.001) were related to postoperative erectile function recovery. In the multivariate analysis, nerve-sparing surgery remained statisticaly significant.
  
  
  CONCLUSIONS
  The functional results in preserving cystectomy are promising. The preservation should be considered in young patients without erectile dysfunction.
authors.affiliation: Departamento de Urología, Hospital Clínic de Barcelona, Barcelona, España. Electronic address: tonivilaseca@hotmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Vilaseca
authors.forename: E
authors.initials: E
authors.lastname: García-Cruz
authors.forename: M J
authors.initials: MJ
authors.lastname: Ribal
authors.forename: M
authors.initials: M
authors.lastname: Pérez Márquez
authors.forename: A
authors.initials: A
authors.lastname: Alcaraz
mesh_terms: D015653:Cystectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments; D010410:Penile Erection; D010413:Penis / Q000098:blood supply* / Q000294:innervation*; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000601:surgery*
keywords: Cistectomía radical; Continencia urinaria; Erectile function; Función eréctil; Neurovascular preservation; Preservación neurovascular; Radical cystectomy; Urinary continence