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Erectile dysfunction after radical prostatectomy: the impact of nerve-sparing status and surgical approach

International Journal of Impotence Research volume 24, pages 155–160 (2012)Cite this article

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Abstract

The core question of the study was whether the nerve-sparing status and surgical approach affected the patients’ sexual life in the first year after surgery. In addition, determinants of erectile function (EF) and the extent of sexual activity were investigated. We conducted a multicentric, longitudinal study in seven German hospitals before, 3, 6 and 12 months after radical prostatectomy (RP). A total of 329 patients were asked to self-assess the symptoms associated with erectile dysfunction (ED). These symptoms were assessed using the International Index of Erectile Function and EORTC QLQ-PR25 questionnaires. A multiple regression model was used to test the influence of clinical, socio-demographic and quality-of-life-associated variables on the patients’ EF 1 year after RP. Before surgery, 39% of patients had a severe ED (complete impotence). At 3, 6 and 12 months after surgery, it was 80, 79 and 71%, respectively. Although the surgical approach had no significant effect on EF, patients who had undergone nerve-sparing surgery had significantly lower ED rates. Nevertheless, 1 year after RP, 66% of these patients had severe ED. Age, nerve-sparing status and the burden of urinary symptoms had the greatest impact on the patients’ EF. Regardless of nerve-sparing status and surgical approach, postsurgical improvement of EF does not mean a full convalescence of presurgical EF. Instead, it may rather reduce the degree of postsurgical ED in time. Consequently, urologists should disclose to the patient that ED is a likely side effect of RP.

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Acknowledgements

The study was sponsored by the German Cancer Aid (Deutsche Krebshilfe e.V.).

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Authors and Affiliations

  1. Department of Medical Psychology and Medical Sociology, University of Leipzig, Germany

    N Koehler, S Holze, L Gansera & E Braehler

  2. Department of Urology, University of Leipzig, Germany

    S Holze

  3. Diakonissenkrankenhaus Dessau, Dessau, Germany

    U Rebmann

  4. Helios Klinikum Wuppertal, Germany

    S Roth

  5. Asklepios Klinik Weissenfels, Weissenfels, Germany

    H-J Scholz

  6. Zeisigwaldkliniken Bethanien Chemnitz, Germany

    D Fahlenkamp

  7. Knappschaftskrankenhaus Dortmund, Germany

    R Thiel

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  1. N Koehler
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Correspondence to N Koehler.

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Koehler, N., Holze, S., Gansera, L. et al. Erectile dysfunction after radical prostatectomy: the impact of nerve-sparing status and surgical approach. Int J Impot Res 24, 155–160 (2012). https://doi.org/10.1038/ijir.2012.8

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  • DOI: https://doi.org/10.1038/ijir.2012.8

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