Back to Baseline: Erectile Function Recovery after Radical Prostatectomy from the Patients' Perspective

Autor: John P. Mulhall, James A. Eastham, Christian J. Nelson, Peter T. Scardino
Rok vydání: 2013
Předmět:
Zdroj: The Journal of Sexual Medicine. 10:1636-1643
ISSN: 1743-6095
Popis: 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.This study explores EFR defined as BTB.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.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.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%, P0.001), which remained a significant predictor (OR = 6.25, 95% CI: 1.88 to 50, P0.001) in multivariable analysis.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.
Databáze: OpenAIRE