INTRODUCTION: A variety of erectile function recovery (EFR) rates are reported post-radical prostatectomy (RP), with some suggesting EFR rates over 90% [1]. Clinical experience suggests that patients view EFR as getting back to their baseline (BTB) erectile functioning (EF) without the use of medication. AIM: This study explores EFR defined as BTB. METHOD: Men pre-RP and 24 months post-RP completed the Erectile Function Domain (EFD) of the International Index of Erectile Function and one question on phosphodiesterase type 5 inhibitor (PDE5i) use. Men using a PDE5i at baseline were excluded. MAIN OUTCOME MEASURES: At 24 m, "back to baseline" was defined as achieving the baseline EFD score (within 1 point or higher). Analyses included descriptive statistics, chi-square, and logistic regression. RESULTS: One hundred eighty men had an average age at RP of 59 (SD = 7) years. When including men who were using a PDE5i at 24 months, 43% (N = 78, 95% CI: 36-51%) returned BTB. When considering BTB without the use of a PDE5i, 22% (N = 39, 95% CI: 16% to 28%) returned BTB. When focusing on a subset of men with baseline EFD ≥ 24 (N = 132), 36% (N = 47, 95% CI: 28% to 44%) returned BTB at 24 months using a PDE5i and 16% (N = 21, 95% CI: 11% to 23%) without the use of a PDE5i. For this group, there was a significant difference by age (<60 years, 23% vs. ≥ 60 years, 4%, P < 0.001), which remained a significant predictor (OR = 6.25, 95% CI: 1.88 to 50, P < 0.001) in multivariable analysis. CONCLUSIONS: Twenty-two percent of the entire sample and 16% of the men with functional (EFD ≥ 24) baseline erections returned to BTB EF without the use of medication. Only 4% of men who were ≥ 60 years old with functional erections pre-surgery achieved BTB EF. Although gaining partial EF is also important, men pre-RP should be educated on EFR and the chance of "back to baseline" EF.
INTRODUCTION: A variety of erectile function recovery (EFR) rates are reported post-radical prostatectomy (RP), with some suggesting EFR rates over 90% [1]. Clinical experience suggests that patients view EFR as getting back to their baseline (BTB) erectile functioning (EF) without the use of medication. AIM: This study explores EFR defined as BTB. METHOD:Men pre-RP and 24 months post-RP completed the Erectile Function Domain (EFD) of the International Index of Erectile Function and one question on phosphodiesterase type 5 inhibitor (PDE5i) use. Men using a PDE5i at baseline were excluded. MAIN OUTCOME MEASURES: At 24 m, "back to baseline" was defined as achieving the baseline EFD score (within 1 point or higher). Analyses included descriptive statistics, chi-square, and logistic regression. RESULTS: One hundred eighty men had an average age at RP of 59 (SD = 7) years. When including men who were using a PDE5i at 24 months, 43% (N = 78, 95% CI: 36-51%) returned BTB. When considering BTB without the use of a PDE5i, 22% (N = 39, 95% CI: 16% to 28%) returned BTB. When focusing on a subset of men with baseline EFD ≥ 24 (N = 132), 36% (N = 47, 95% CI: 28% to 44%) returned BTB at 24 months using a PDE5i and 16% (N = 21, 95% CI: 11% to 23%) without the use of a PDE5i. For this group, there was a significant difference by age (<60 years, 23% vs. ≥ 60 years, 4%, P < 0.001), which remained a significant predictor (OR = 6.25, 95% CI: 1.88 to 50, P < 0.001) in multivariable analysis. CONCLUSIONS: Twenty-two percent of the entire sample and 16% of the men with functional (EFD ≥ 24) baseline erections returned to BTB EF without the use of medication. Only 4% of men who were ≥ 60 years old with functional erections pre-surgery achieved BTB EF. Although gaining partial EF is also important, men pre-RP should be educated on EFR and the chance of "back to baseline" EF.
Authors: Anna Bill-Axelson; Lars Holmberg; Mirja Ruutu; Michael Häggman; Swen-Olof Andersson; Stefan Bratell; Anders Spångberg; Christer Busch; Stig Nordling; Hans Garmo; Juni Palmgren; Hans-Olov Adami; Bo Johan Norlén; Jan-Erik Johansson Journal: N Engl J Med Date: 2005-05-12 Impact factor: 91.245
Authors: Florian R Schroeck; Tracey L Krupski; Leon Sun; David M Albala; Marva M Price; Thomas J Polascik; Cary N Robertson; Alok K Tewari; Judd W Moul Journal: Eur Urol Date: 2008-06-23 Impact factor: 20.096
Authors: Jim C Hu; Xiangmei Gu; Stuart R Lipsitz; Michael J Barry; Anthony V D'Amico; Aaron C Weinberg; Nancy L Keating Journal: JAMA Date: 2009-10-14 Impact factor: 56.272
Authors: Kristine A Donovan; Brian D Gonzalez; Ashley M Nelson; Mayer N Fishman; Babu Zachariah; Paul B Jacobsen Journal: Psychooncology Date: 2017-06-27 Impact factor: 3.894