A Retrospective Study of Erectile Function and Use of Erectile Aids in Prostate Cancer Patients After Radical Prostatectomy in Denmark

Abstract

IntroductionRadical prostatectomy (RP) offers a good long-term cancer control for clinically localized prostate cancer. However, complications such as erectile dysfunction and substantial decreases quality of life of the afflicted men and their sexual partners. Identification of pre-, per-, and postoperative factors that correlate with poor postoperative erectile status must be considered an important step to improving penile rehabilitation.AimTo describe postoperative erectile function after RP in a Danish cohort.MethodsThe medical records of 1,127 patients undergoing RP from March 2003 through September 2014 were reviewed retrospectively with a 12-month follow-up after surgery. In all, 704 patients fulfilling the inclusion criteria were included in the final analysis. Recovery was defined as self-reported erection sufficient for intercourse (ESI) with or without usage of erectile aids.Main Outcome MeasuresSubjective reporting of erectile function and usage erectile aids 12 months after RP.ResultsESI with or without erectile aids was reported by 226 men (32.1%), among whom 109 (48.2%) required erectile aids. Erectile dysfunction (ED) was reported by 478 men (67.9%) and by 121 (25.3%) despite use of erectile aids. Of men with ED, 155 (22%) stated not being interested in penile rehabilitation, 26 (3.7%) stated not having resumed their sex life 12 months after RP, and 241 (34.2%) had ED and were unsatisfied with the condition. We found that 134 of 445 men (30.1%) who underwent non–nerve-sparing RP had ESI 12 months after RP. Age older than 60.5 years, a high body mass index, comorbidity, and a high American Society of Anesthesiologists score were negative predictors of erectile function 12 months after RP.ConclusionTwelve months after RP, 32.1% of men had ESI; half these men required the use of erectile aids. Age older than 60.5 years, a high body mass index, comorbidity, and a high American Society of Anesthesiologists score were negative predictors for ED 12 months after RP.Haahr MK, Azawi NH, Andersen LG, et al. A Retrospective Study of Erectile Function and Use of Erectile Aids in Prostate Cancer Patients After Radical Prostatectomy in Denmark. Sex Med 2017;5:e156–e162.

A 12-Month Follow-up After a Single Intracavernous Injection of Autologous Adipose-Derived Regenerative Cells in Patients with Erectile Dysfunction Following Radical Prostatectomy: An Open-Label Phase I Clinical Trial

“…In general, reported degrees of ED after RP vary greatly (14-86%) depending on risk stratification and patient selection, the experience of the surgeon, type of operation, and the measure and definition of ED [33]. Results from our own department shows only 32% recover erectile function sufficient for intercourse 12 months after RP [34]…”

Scandinavian Prostate Cancer Patients’ Sexual Problems and Satisfaction With Their Sex Life Following Anti-Cancer Treatment

“…Despite these limitations, using a large sample of Scandinavian men, this study underscores a strong clinical need to address the possibility of sexual problems and reduced sexual satisfaction among prostate cancer patients who are sexually active prior to treatment onset, even when these patients are relatively old. For health care personnel targeting the sexual rehabilitation of patients, this process may include providing information, concrete advice, and specific suggestions; following the PLISSIT model 39 ; a penile and sexual health and well-being program 40 ; as well as addressing solo and partnered sexual activity and satisfaction. 20 , 21 , 31 In this connection, as different kinds of treatments strategies of prostate cancer are associated with different patterns of adverse effects over time (eg, urinary incontinence, bowel problems, and sexual dysfunctions) 41 when promoting treatment decisions that incorporate sexual health and rehabilitation, these needs to be co-considered.…”

Rehabilitation Effect of Correction of Erectile Dysfunction in Patients Who Underwent Radical Prostatectomy for Prostate Cancer

“…С одной стороны, они связаны с оказанием психологической поддержки, а иногда и психиатрической помощи, и имеются публикации об эффективности этих мероприятий [21][22][23], а с другой -с мероприятиями по восстановлению возможности половой жизни. Из больных с развившейся после операции ЭД 34,2% хотели бы улучшить сексуальную функцию [6].…”

“…При анкетировании больных, перенесших РПЭ, о сохранении эректильной функции сообщили 32,1% пациентов, однако почти половина из них использовали вспомогательные средства. У 67,9% была значительная ЭД, причем из них 25,3% пациентов безуспешно применяли вспомогательные средства [6].…”