title: Effect of Nerve-Sparing Radical Prostatectomy on Urinary Continence in Patients With Preoperative Erectile Dysfunction.
abstract: OBJECTIVE
  We aimed to assess whether nerve-sparing radical prostatectomy (nsRP) is associated with improved recovery of urinary continence compared to non-nerve-sparing radical prostatectomy (nnsRP) in patients with localized prostate cancer and preoperative erectile dysfunction.
  
  
  METHODS
  A total of 360 patients with organ-confined prostate cancer and an International Index of Erectile Function score of less than 17 were treated with nsRP or nnsRP in Seoul St. Mary's Hospital. Patients who received neoadjuvant or adjuvant androgen deprivation therapy or had a history of prostate-related surgery were excluded. Recovery of urinary continence was assessed at 0, 1, 3, 6, and 12 months. Postoperative recovery of continence was defined as zero pad usage. The association between nerve-sparing status and urinary continence was assessed by using univariate and multivariate Cox regression analyses after controlling for known predictive factors.
  
  
  RESULTS
  Urinary continence recovered in 279 patients (77.5%) within the mean follow-up period of 22.5 months (range, 6-123 months). Recovery of urinary continence was reported in 74.6% and 86.4% of patients after nnsRP and nsRP, respectively, at 12 months (P=0.022). All groups had comparable perioperative criteria and had no significant preoperative morbidities. Age, American Society of Anesthesiologists score, and nerve-sparing status were significantly associated with recovery of urinary continence on univariate analysis. On multivariate analysis, age (hazard ratio [HR], 1.254; 95% confidence interval [CI], 1.002-1.478; P=0.026) and nerve-sparing status (HR, 0.713; 95% CI, 0.548-0.929; P=0.012) were independently associated with recovery of urinary continence.
  
  
  CONCLUSIONS
  nsRP, as compared to nnsRP, improves recovery rates of urinary incontinence and decreases surgical morbidity without compromising pathologic outcomes.
authors.affiliation: Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea.
authors.forename: Yong Hyun
authors.identifier: 0000-0003-4860-6127
authors.initials: YH
authors.lastname: Park
authors.affiliation: Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea.
authors.forename: Oh Seong
authors.identifier: 0000-0002-8933-6656
authors.initials: OS
authors.lastname: Kwon
authors.affiliation: Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea.
authors.forename: Sung-Hoo
authors.identifier: 0000-0002-1952-4010
authors.initials: SH
authors.lastname: Hong
authors.affiliation: Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea.
authors.forename: Sae Woong
authors.identifier: 0000-0002-9127-9400
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea.
authors.forename: Tae-Kon
authors.identifier: 0000-0001-7128-7422
authors.initials: TK
authors.lastname: Hwang
authors.affiliation: Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea.
authors.forename: Ji Youl
authors.identifier: 0000-0001-6775-1157
authors.initials: JY
authors.lastname: Lee
keywords: Erectile Dysfunction; Nerve-Sparing; Prostate Neoplasms; Prostatectomy; Urinary Incontinence