Erectile dysfunction associated with radical prostatectomy: appropriateness and methods to preserve potency

• DOI: 10.18565/urology.2018.2.75-82
• Publication Date: 2018-06-14T10:40:42Z
• Authors: E.V. Shpot’ Shpot’; D.V. Chinenov Chi...; A.V. Amosov Amosov; Ya.N. Chernov Che...; M.V. Yurova Yurova; Yu.V. Lerner Lerner
• Keywords: Nerve sparing; Nomogram

Erectile dysfunction (ED) associated with radical prostatectomy (RP) affects 25-75% of patients and has a significant negative impact on their quality life AIM: To analyze the maintenance erectile function after RP depending type endoscopic access nerve-sparing.This retrospective study comprised 231 localized prostate cancer, who underwent surgery between February 2015 2016. Surgery was performed using one three approaches: laparoscopic, extraperitoneoscopic or robot-assisted. Nerve-sparing chosen were based Briganti nomogram (low risk extraprostatic extension), Partins table, taking into account desire to maintain EF. EF evaluated International Index Function (IIEF-5) questionnaire QoL (Quality Life) scale.Nerve-sparing in 153 patients. did not differ significantly from non-nerve sparing regard operative time (p=0.064) blood loss (p=0.073). According pathomorphological study, prostatic capsule intact, surgical margins all cases. The incidence ED complete greater compared nerve [(5.0 (0-10.0) vs. 6.5 (0.8-19,0) points according IIEF-5 scale, p=0.271)]; 96.2% versus 72.2% (p<0.001). had statistically better effect life: 1.63+/-1.16 against 1.88+/-1.02 (p=0.035).The best outcomes observed undergoing robot-assisted RP. resulted lower rate ED. This advantage without compromising completeness resection allows us consider nerve-sparing as an appropriate validated modality preventing properly selected