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Erectile haemodynamic status after radical prostatectomy correlates with erectile functional outcome
Author(s) -
Ohebshalom Michael,
Parker Marilyn,
Waters Bedford,
Flanagan Robert,
Mulhall John P.
Publication year - 2008
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.2008.07695.x
Subject(s) - medicine , erectile dysfunction , hemodynamics , urology , prostatectomy , prospective cohort study , radical retropubic prostatectomy , surgery , prostate , cancer
OBJECTIVE To define haemodynamic changes after radical retropubic prostatectomy (RP) and the predictive value of these for the outcome of erectile function (EF), as although there are predictors of the recovery of EF, penile vascular changes might also affect the recovery of EF. PATIENTS AND METHODS Prospective data were analysed from men who had RP followed by duplex penile Doppler ultrasonography (DUS) within 6 months of RP. All men had functional erections before RP, based on self‐report and partner corroboration, and all completed the International Index of Erectile Function (IIEF) questionnaire serially after RP. The EF, based on IIEF scores, was then correlated with the penile DUS results. RESULTS In all, the study included 111 patients; 32 (29%) had normal erectile haemodynamics after RP, while 79 (71%) had abnormal haemodynamics. Twelve patients (11%) had a venous leak. There were no differences in mean patient age or comorbidity profile between those with and without haemodynamic changes. Comparing those with normal and abnormal haemodynamics, the mean IIEF EF domain scores were 25 and 17 ( P = 0.025), the percentages of erectile rigidity at 18 months was 66% vs 35% ( P = 0.013), the percentage of patients with normal EF domain scores was 28% vs 6% ( P < 0.01), the percentage of patients with functional erections permitting sexual intercourse unassisted by pharmacological agents was 47% vs 22% ( P = 0.018), and the percentage of patients responding to sildenafil citrate, as defined by vaginal penetration, was 72% vs 43% ( P = 0.03), respectively. CONCLUSIONS The results of this prospective study indicate that a patient’s penile vascular status is correlated with their EF after RP.