title: Erectile function recovery after robotic-assisted radical prostatectomy (RARP): long term exhaustive analysis across all preoperative potency categories.
abstract: BACKGROUND
  To evaluate erectile function recovery following robotic-assisted radical prostatectomy (RARP) according to preoperative sexual health inventory for men (SHIM) score stratification.
  
  
  METHODS
  We prospectively collected data on 250 consecutive patients who underwent RARP by a single surgeon between October 2006 and October 2012. Thirty-six patients were excluded because of lack of preoperative SHIM score. All patients had a minimum follow up of 2 years. Patients were divided into four groups according to their preoperative SHIM score: group 1 with normal potency (SHIM 22-25), group 2 with mild ED (SHIM 17-21), group 3 with mild-moderate ED (SHIM 12-16) and group 4 with moderate-severe ED (SHIM 1-11). Patients were followed at 3, 6, 9, 12, 18, 24 months intervals and twice yearly thereafter. SHIM questionnaire and erection hardness scale (EHS) score were collected at each visit. Potency was defined as successful penetration during intercourse (EHS score 3-4) with or without phosphodiesterase type 5-inhibitor (PDE5-I).
  
  
  RESULTS
  After exclusion, 214 patients were evaluated. The number of patients in group 1, 2, 3 and 4 were 95, 59, 26 and 34, respectively. At 3, 6, 9, 12, 18, 24 months, SHIM scores and potency rates were statistically different between groups 1 versus 2 versus 3 versus 4 (p < 0.01, at each time point). Patients in each group 1, 2 and 3 showed a statistically significant improvement in potency rates and SHIM scores at consecutive follow up visits up to 24 months (p < 0.01, for each potency group). Potency rates at 24 months for groups 1 to 4 were 83.3%, 54.5%, 50.0%, and 20.7%, respectively (p < 0.001).
  
  
  CONCLUSIONS
  For proper patient counseling and better prediction of erectile function recovery after RARP, it is important to stratify patients according to preoperative SHIM scores. Setting realistic expectations may increase patient satisfaction.
authors.affiliation: Division of Robotic Urology, Hôpital du Sacré Cœur de Montréal, Montréal, Quebec, Canada.
authors.forename: Abdullah M
authors.initials: AM
authors.lastname: Alenizi
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Zorn
authors.forename: Marc
authors.initials: M
authors.lastname: Bienz
authors.forename: Emad
authors.initials: E
authors.lastname: Rajih
authors.forename: Pierre Alain
authors.initials: PA
authors.lastname: Hueber
authors.forename: Naif
authors.initials: N
authors.lastname: Al-Hathal
authors.forename: Serge
authors.initials: S
authors.lastname: Benayoun
authors.forename: Thierry
authors.initials: T
authors.lastname: Lebeau
authors.forename: Assaad
authors.initials: A
authors.lastname: El-Hakim
mesh_terms: D000368:Aged; D002170:Canada; D007172:Erectile Dysfunction / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D005500:Follow-Up Studies; D006801:Humans; D000069451:Long Term Adverse Effects; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods; D011471:Prostatic Neoplasms / Q000601:surgery*; D011788:Quality of Life; D020127:Recovery of Function; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D011795:Surveys and Questionnaires; D016896:Treatment Outcome