Among men undergoing radical retropubic prostatectomy (RRP) for localized prostate cancer, younger age, bilateral nerve sparing, and good surgical technique improve the likelihood of a return to potency after surgery.
Mark Soloway, MD, and his colleagues at the University of Miami Miller School of Medicine examined factors influencing erectile function in 797 men who were potent prior to surgery and did not receive neo-adjuvant or adjuvant therapy within six months of RRP.
Of 619 men who had a bilateral and 178 who had a unilateral nerve-sparing RRP, 72% and 53%, respec-tively, were potent, defined as having erectile function sufficient for intercourse with or without a phosphodiesterase-5 inhibitor.
The potency rates were 86%, 76%, 58%, and 37% for patients aged 49 years or less, 50-59 years, 60-69 years, and 70 years and older, respectively, Dr. Soloway’s group reported in BJU International (2008; 101:833-836). In all age groups, potency was more common after bilateral than unilateral nerve-sparing surgery.
“Careful patient selection and meticulous surgical technique are essential to achieve the right balance between cancer control and morbidity,” the authors concluded.