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Local steroid application during nerve‐sparing radical retropubic prostatectomy
Author(s) -
Deliveliotis Charalambos,
Delis Athanasios,
Papatsoris Athanasios,
Antoniou Nikos,
Varkarakis Ioannis M.
Publication year - 2005
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2005.05679.x
Subject(s) - medicine , neurovascular bundle , potency , urology , prostate cancer , prostatectomy , radical retropubic prostatectomy , surgery , betamethasone , prostate , neck of urinary bladder , cancer , urinary bladder , biochemistry , chemistry , in vitro
OBJECTIVE To evaluate the effect on potency rates after surgery of applying local steroids to the neurovascular bundles (NVBs) of the prostate after bilateral nerve‐sparing radical retropubic prostatectomy (BNS‐RRP). PATIENTS AND METHODS Sixty potent men undergoing BNS‐RRP for clinically localized prostate cancer were prospectively randomized equally into two groups. In group 1, 10 mL of betamethasone cream 0.1% was applied locally to both NVBs, and group 2 had only the usual BNS‐RRP with no corticoid cream. Complications and potency were evaluated at 3, 6 and 12 months in all patients and compared between the groups. RESULTS At 12 months, 57% and 60% of patients were potent in group 1 and 2, respectively; the respective mean International Index of Erectile Function (5‐item) scores were 14.76 and 15.43 ( P = 0.59). Potency rates at 3, 6 and 12 months were not significantly different between the groups, and the continence rates at 12 months were also similar, with 93% and 90% of patients in groups 1 and 2 being continent, respectively. Ten and five patients in groups 1 and 2, respectively, required a blood transfusion ( P = 0.23). There were no fistulae, wound dehiscence or rectal perforations. One patient in group 2 presented 4 months after RRP with a bladder neck contracture. CONCLUSIONS Local application of betamethasone does not improve or expedite the recovery of erectile function after BNS‐RRP, but there were no complications associated with its use.