title: Ten-year outcomes of sexual function after radical prostatectomy: results of a prospective longitudinal study.
abstract: BACKGROUND
  The long-term impact of radical prostatectomy (RP) on sexual function (SF) and erectile function (EF) has important implications related to the risk-to-benefit ratio of this treatment.
  
  
  OBJECTIVE
  To determine the long-term effect of RP on male SF and EF over 10 yr of follow-up.
  
  
  METHODS
  This was a prospective, longitudinal outcomes study in 1836 men following RP at a university hospital. Men were invited to complete the University of California, Los Angeles, Prostate Cancer Index SF survey at baseline, 3, 6, 12, 24, 96, and 120 mo postoperatively and a survey at 4 and 7 yr postoperatively assessing global changes in their EF over the preceding 2 yr.
  
  
  METHODS
  All men underwent open RP.
  
  
  METHODS
  Multiple, generalized linear regression models were used to evaluate the association between time following RP and SF and EF scores controlling for age, prostate-specific antigen, Gleason scores, stage, nerve sparing, race, and marital status.
  
  
  CONCLUSIONS
  After an expected initial decline, time-dependent improvements in SF and EF were observed through 2 yr postoperatively. Overall, SF and EF were both generally stable between 2 and 10 yr following RP. The subgroups of younger men and men with better preoperative function were more likely to maintain their EF and SF through 10 yr following RP. The primary limitation is the potential bias attributable to nonresponders.
  
  
  CONCLUSIONS
  The recovery of EF can extend well beyond 2 yr. There is a significant association between younger age and better preoperative function and the likelihood of experiencing improvements beyond 2 yr. Assessing the comparative effectiveness of treatment options for localized prostate cancer must examine SF beyond 2 yr to account for delayed treatment effects and the natural history of SF in the aging male population.
authors.affiliation: Department of Urology, New York University School of Medicine, New York, NY, USA.
authors.forename: Ganesh
authors.initials: G
authors.lastname: Sivarajan
authors.forename: Vinay
authors.initials: V
authors.lastname: Prabhu
authors.forename: Glen B
authors.initials: GB
authors.lastname: Taksler
authors.forename: Juliana
authors.initials: J
authors.lastname: Laze
authors.forename: Herbert
authors.initials: H
authors.lastname: Lepor
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D011446:Prospective Studies; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery*; D019529:Sexuality; D013997:Time Factors; D016896:Treatment Outcome
keywords: Erectile dysfunction; Prostate cancer; Prostatectomy; Quality of life