San Diego, CA USA (UroToday.com) With robotic prostatectomy widely used to treat prostate cancer, recovery of sexual function is an important outcome to measure. The International Index of Erectile Function questionnaire (IIEF-5) is routinely used to measure sexual function in relation to robot-assisted radical prostatectomy RARP, however it does not account for partner non-participation and has other confounders.
In this study, 1,200 pre-potent men (IIEF-5 >21) who underwent a RARP by a single surgeon were evaluated for return of potency at three months and followed for 24 months. The men in addition to completing the IIEF-5 post-operatively, were also asked to rate the percent fullness of their erections compared to pre-op. Four % fullness groups were revealed: 0-24%, 25-49% 50-74% and 75-100%. At three month post-RP, 1% of the men in the 0-24% fullness group had recovered sexual function, compared to 8% in the 25-49%, 21% in the 50-74% and 82% in the 75-100% fullness groups. The odds ratio for predictability of recovery of potency at 24 months at three months was 116.80 when stratifying percent fullness <25% compared to >75%.
In conclusion, the group presented an easy method, asking “What is the % fullness of your erections compared to before surgery,” to help predict recovery of sexual function at three months after RARP. This method can be adapted by surgeons to council patients on expectation of recovery. Moreover, 50% of men with the lowest quartile of fullness do recover potency by two years. Further investigations are needed to elucidate factors that might help identify men who would benefit from interventional therapies.
Presented By: Thomas Ahlering, MD
Written By: Blanca Morales, Department of Urology, University of California, Irvine at the 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA