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Recovery of sexual function after nerve‐sparing radical prostatectomy or cystectomy
Author(s) -
Miyao Noriomi,
Adachi Hideki,
Sato Yoshikazu,
Horita Hiroki,
Takahashi Atsushi,
Masumori Naoya,
Kitamura Hiroshi,
Tsukamoto Taiji
Publication year - 2001
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1046/j.1442-2042.2001.00274.x
Subject(s) - medicine , prostatectomy , urology , sexual function , cystectomy , sexual intercourse , nerve sparing , erectile function , erectile dysfunction , prostate cancer , surgery , cancer , bladder cancer , population , environmental health
Background: The recovery of sexual function (erectile function and frequency of sexual intercourse) over time after nerve‐sparing radical prostatectomy or cystoprostatectomy was evaluated. Methods: Forty‐nine consecutive patients with clinically localized prostate cancer and muscle‐invasive bladder cancer were treated with radical prostatectomy and radical cystoprostatectomy with a nerve‐sparing procedure. Erectile function was evaluated by the circumferential change of the penis during nocturnal penile tumescence (NPT value) with an erectometer before and after surgery. Erectile function and the frequency of sexual intercourse were also evaluated with a self‐administered questionnaire before and after surgery. Multivariate analysis by Cox's proportional hazards model was used to evaluate the factor(s) that affected the recovery of erectile function and sexual intercourse. Results: The recovery rates of erectile function were 49% at 3 years and 79% at 5 years. For recovery of sexual intercourse the rates were 36% at 3 years and 57% at 5 years. Multivariate analysis revealed that the preoperative NPT value was the only independent factor which significantly affected the recovery of erectile function. The age at surgery was a significant factor for recovery of sexual intercourse. Conclusion: Nerve‐sparing operations can often, but not always, provide preservation or recovery of erectile function for patients who receive radical prostatectomy or cystoprostatectomy. Recovery of erectile function depends upon the preoperative NPT value and recovery of sexual intercourse depends upon the age of the patient.