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J Sex Med. 2013 Jun;10(6):1636-43. doi: 10.1111/jsm.12135. Epub 2013 Apr 3.

Back to baseline: erectile function recovery after radical prostatectomy from the patients' perspective.

Author information

1
Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY 10022, USA. nelsonc@MSKCC.ORG

Abstract

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.

PMID:
23551767
PMCID:
PMC4742368
DOI:
10.1111/jsm.12135
[Indexed for MEDLINE]
Free PMC Article
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