title: Unexpected Long-term Improvements in Urinary and Erectile Function in a Large Cohort of Men with Self-reported Outcomes Following Radical Prostatectomy.
abstract: BACKGROUND
  It is generally assumed that if a man does not regain urinary continence or erectile function within 12 mo of radical prostatectomy (RP), then the chance of subsequent recovery is low.
  
  
  OBJECTIVE
  To determine the probability of achieving good urinary function (UF) or erectile function (EF) up to 48 mo postoperatively in men who reported poor UF or EF at 12 mo after RP.
  
  
  METHODS
  We identified 3187 patients who underwent RP from 2007 through 2013 at a tertiary institution and had extended multidisciplinary follow-up with patient-reported UF and EF scores at ≥12 mo.
  
  
  METHODS
  Open or minimally invasive RP.
  
  
  METHODS
  Primary outcome was good UF as defined by a urinary score ≥17 (range: 0-21) or good EF as defined by a modified International Index of Erectile Function-6 score ≥22 (range: 1-30). The probability of functional recovery beyond 12 mo was determined by Kaplan-Meier analyses.
  
  
  CONCLUSIONS
  Among patients incontinent at 12 mo, the probability of achieving good UF at 24, 36, and 48 mo was 30%, 49%, and 59%. In patients experiencing erectile dysfunction at 12 mo, the probability of recovering EF at 24, 36, and 48 mo was 22%, 32%, and 40%. On multivariable analyses, 12-mo functional score and age were associated with recovery, but only score was consistently significant.
  
  
  CONCLUSIONS
  Men with incontinence or erectile dysfunction at 12 mo have higher than anticipated rates of subsequent functional improvement. Probability of recovery is strongly influenced by score at 12 mo. Further research should address the impact of ongoing multidisciplinary follow-up care on our observed rates of recovery.
  
  
  RESULTS
  Many prostate cancer patients continue to recover urinary and erectile function after 12 mo. The level of functional recovery by 12 mo is associated with long-term recovery and should be discussed by the physician and patient when deciding on rehabilitative interventions.
authors: Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA. Electronic address: leej6@mskcc.org.
authors: Justin K
authors: JK
authors: Lee
authors: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors: Melissa
authors: M
authors: Assel
authors: Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors: Alan E
authors: AE
authors: Thong
authors: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors: Daniel D
authors: DD
authors: Sjoberg
authors: Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors: John P
authors: JP
authors: Mulhall
authors: Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors: Jaspreet
authors: J
authors: Sandhu
authors: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors: Andrew J
authors: AJ
authors: Vickers
authors: Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors: Behfar
authors: B
authors: Ehdaie
mesh_terms: D000368:Aged; D015331:Cohort Studies; D007172:Erectile Dysfunction / Q000503:physiopathology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery*; D020127:Recovery of Function; D057566:Self Report; D014549:Urinary Incontinence / Q000503:physiopathology*
keywords: Erectile dysfunction; Patient-reported outcomes; Radical prostatectomy; Urinary incontinence