title: Comprehensive analysis of sexual function outcome in prostate cancer patients after robot-assisted radical prostatectomy.
abstract: OBJECTIVE
  The recovery of potency following radical prostatectomy is complex and has a very wide range. In this study, we analyzed in detail the precise pattern of recovery of potency following robot-assisted radical prostatectomy (RARP).
  
  
  METHODS
  Prospectively collected database of patients with a minimum follow-up of 1 year after RARP were evaluated retrospectively. Of 503 patients identified, 483 patients completed the sexual health inventory for men (SHIM) preoperatively and postoperatively every 3 months for the first 12 months. Overall potency, usage of phosphodiesterase type-5 (PDE-5) inhibitors, and return to baseline erectile function were evaluated. Potency was defined as having erection that is sufficient for sexual intercourse more than 50% of attempts, while quality potency was defined as being potent without the use of PDE-5 inhibitors.
  
  
  RESULTS
  Preoperatively, the overall potency and quality potency rate were 67.1% and 48.1%, respectively. Postoperatively, the overall potency rate was 61.4%, while the quality potency rate was 37.2%. In multivariate regression analysis, independent predictors of potency recovery were young age (<60), preoperative potency status, and bilateral preservation of neurovascular bundles (NVBs). In men with SHIM>21, the overall potency and quality potency rate were 79.7% and 41.2%, respectively. More importantly, only 21.4% of the men with normal erection preoperatively (SHIM>21) returned to baseline erectile function (SHIM>21) 12 months after surgery.
  
  
  CONCLUSIONS
  This study indicates that young age (<60), preoperative potency, and bilateral preservation of NVBs were positive predictors of potency recovery following RARP. However, an overwhelming majority of men experience a deterioration in the overall quality of erection after RARP.
authors.affiliation: 1 Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey , New Brunswick, New Jersey.
authors.forename: Seung Hyo
authors.initials: SH
authors.lastname: Woo
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Kang
authors.forename: Yun-Sok
authors.initials: YS
authors.lastname: Ha
authors.forename: Amirali Hassanzadeh
authors.initials: AH
authors.lastname: Salmasi
authors.forename: Jeong Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Dong-Hyeon
authors.initials: DH
authors.lastname: Lee
authors.forename: Wun-Jae
authors.initials: WJ
authors.lastname: Kim
authors.forename: Isaac Yi
authors.initials: IY
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D007172:Erectile Dysfunction / Q000175:diagnosis* / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012371:Robotics; D015996:Survival Rate