Orgasmic Function after Radical Prostatectomy.
We examined postprostatectomy orgasmic function and assessed for potential predictors.



Between 2005 and 2013, 499 men underwent radical prostatectomy and completed quality of life questionnaires prospectively before surgery and at regular postoperative intervals. We used mixed effects logistic regression models to evaluate average differences in followup measures and interactions with time.



At a median followup of 36 months orgasmic function was worse, stable or improved in 300 (60.1%), 152 (30.5%) and 47 men (9.4%), respectively. Orgasmic function recovery plateaued at 15 to 21 months. High postoperative orgasmic function was positively associated with younger age (50 years or younger vs 51 to 60 OR 3.40, 95% CI 1.56-7.41), nerve sparing (bilateral OR 7.11, 95% CI 2.55-19.77, modified 4.34, 95% CI 1.38-13.58 and unilateral OR 3.93, 95% CI 1.17-13.16), erectile function (OR 4.67, 95% CI 3.32-6.57) and sexual desire (OR 5.51, 95% CI 3.95-7.68) but negatively associated with lower urinary tract symptoms (OR 0.58, 95% CI 0.41-0.82) and urinary incontinence (OR 0.38, 95% CI 0.25-0.56). Although robotic status did not influence orgasmic function in the overall cohort, it was associated with faster recovery on subgroup analysis of 356 patients with long followup. On another subgroup analysis of 235 men with long followup and poor erectile function the association of high preoperative orgasmic function and bilateral nerve sparing with high orgasmic function persisted, suggesting an independent effect on orgasmic function apart from that on erectile function.



Orgasmic function recovery after radical prostatectomy is a lengthy process. Predictors of orgasmic function include preoperative orgasmic function, age, nerve sparing status, erectile function, sexual desire and urinary control and function.
Division of Urology, University of Utah, Salt Lake City, Utah. Electronic address: Kefu.Du@hsc.utah.edu.
Kefu
K
Du
Division of Epidemiology, University of Utah, Salt Lake City, Utah.
Chong
C
Zhang
Division of Epidemiology, University of Utah, Salt Lake City, Utah.
Angela P
AP
Presson
Department of Radiation Oncology, University of Utah, Huntsman Cancer Hospital, Salt Lake City, Utah.
Jonathan D
JD
Tward
Division of Urology, University of Utah, Salt Lake City, Utah.
William O
WO
Brant
Division of Urology, University of Utah, Huntsman Cancer Hospital, Salt Lake City, Utah.
Christopher B
CB
Dechet
D000368:Aged; D015331:Cohort Studies; D007172:Erectile Dysfunction / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000453:epidemiology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009948:Orgasm; D010410:Penile Erection; D011183:Postoperative Complications / Q000453:epidemiology* / Q000523:psychology; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery; D011788:Quality of Life; D020127:Recovery of Function; D011795:Surveys and Questionnaires
orgasm; prostate; prostatectomy; prostatic neoplasms; quality of life