Sex Satisfaction Often Declines Post-RP Despite Erection Recovery

CHICAGO—Intercourse satisfaction decreases for most men after radical prostatectomy (RP), even if they recover the penetration hardness erections they had before surgery, researchers reported at the World Meeting on Sexual Medicine.

The findings may assist clinical in counseling patients prior to undergoing RP, investigators concluded.

Christian J. Nelson, PhD, and colleagues at Memorial Sloan-Kettering Cancer Center in New York evaluated 166 men prior to undergoing RP and at 24 months post-RP using the erectile function domain (EFD) and intercourse satisfaction domain (ISD) of the International Index of Erectile Function (IIEF) questionnaire. They also asked subjects whether or not they used phosphodiesterase type 5 (PDE-5) inhibitors. Of the 166 patients, 77 had penetration hardness erections (PHE) at baseline (those with an EFD score of 24 or higher).

Dr. Nelson's group defined erection recovery in two ways: PHE at 24 months and EFD score that returned “back to baseline” (BTB)—a score within one point or higher of baseline—at 24 months.

Subjects had a mean age of 58 years. Their mean baseline and 24-month EFD was 29 and 19.7, respectively, a significant difference in score.

Overall, ISD score decreased significantly from 12 at baseline to 8.3 at 24 months. It even decreased significantly among men with PHE at 24 months (from 12.3 to 11.3). The researchers also observed a significant decrease (from 12.1 to 10.8) in men not using PDE-5 inhibitors and those using the medications (from 12.5 to 11.7).

On multivariable multivariate analysis, only baseline ISD remained a significant predictor of 24-month ISD.

The meeting is cosponsored by the International Society for Sexual Medicine and the Sexual Medicine Society of North America.

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