Abstract
PURPOSE
We determined the effect of nerve sparing radical prostatectomy on sexual and urinary function in men at various levels of pretreatment sexual function.
MATERIALS AND METHODS
Men in the CaPSURE™ (Cancer of the Prostate Strategic Urologic Research Endeavor) database who underwent radical prostatectomy and had baseline and 2-year posttreatment UCLA-PCI sexual function and urinary function scores were selected. Nerve sparing was categorized as bilateral, unilateral or none and the level of pretreatment sexual function was divided into quartiles. The cohort was divided into subgroups of nerve sparing technique and pretreatment sexual function. Differences between sexual function and urinary function among subgroups were determined. A test of interaction was performed between preoperative sexual function and degree of nerve sparing on postoperative sexual function and urinary function scores.
RESULTS
A total of 1,322 patients met the study inclusion criteria. Median patient age was 61 years (range 41 to 79). Bilateral, unilateral and no nerve sparing procedures were performed in 899, 200 and 223 men, respectively. The effects of nerve sparing on sexual function differed among the quartiles of preoperative sexual function (p <0.01). Nerve sparing did not have an effect on the sexual function of men in the lowest quartile of preoperative sexual function score (p = 0.15) but did have a significant beneficial effect on sexual function in the higher 3 quartiles (p = 0.04, p <0.01 and p <0.01, respectively). Alternatively, nerve sparing improved urinary function in men in the lowest quartile of baseline sexual function.
CONCLUSIONS
Nerve sparing radical prostatectomy results in better sexual function outcomes than no nerve sparing in most men except those with little baseline function. Urinary function was positively impacted in all men. Men who are suitable candidates for nerve preservation may benefit from nerve sparing surgery. Poorer baseline sexual function should not exclude these men from such surgery.
TY - JOUR
T1 - Men with low preoperative sexual function may benefit from nerve sparing radical prostatectomy.
AU - Harris,Catherine R,
AU - Punnen,Sanoj,
AU - Carroll,Peter R,
Y1 - 2013/02/11/
PY - 2013/02/06/received
PY - 2013/02/06/accepted
PY - 2013/2/16/entrez
PY - 2013/2/16/pubmed
PY - 2013/12/16/medline
KW - NS
KW - PSA
KW - RP
KW - SB
KW - SF
KW - UB
KW - UF
KW - erectile dysfunction
KW - nerve sparing
KW - physiological
KW - prostate specific antigen
KW - prostatectomy
KW - prostatic neoplasms
KW - radical prostatectomy
KW - sexual bother
KW - sexual dysfunction
KW - sexual function
KW - urinary bother
KW - urinary function
KW - urinary incontinence
SP - 981
EP - 6
JF - The Journal of urology
JO - J Urol
VL - 190
IS - 3
N2 - PURPOSE: We determined the effect of nerve sparing radical prostatectomy on sexual and urinary function in men at various levels of pretreatment sexual function. MATERIALS AND METHODS: Men in the CaPSURE™ (Cancer of the Prostate Strategic Urologic Research Endeavor) database who underwent radical prostatectomy and had baseline and 2-year posttreatment UCLA-PCI sexual function and urinary function scores were selected. Nerve sparing was categorized as bilateral, unilateral or none and the level of pretreatment sexual function was divided into quartiles. The cohort was divided into subgroups of nerve sparing technique and pretreatment sexual function. Differences between sexual function and urinary function among subgroups were determined. A test of interaction was performed between preoperative sexual function and degree of nerve sparing on postoperative sexual function and urinary function scores. RESULTS: A total of 1,322 patients met the study inclusion criteria. Median patient age was 61 years (range 41 to 79). Bilateral, unilateral and no nerve sparing procedures were performed in 899, 200 and 223 men, respectively. The effects of nerve sparing on sexual function differed among the quartiles of preoperative sexual function (p <0.01). Nerve sparing did not have an effect on the sexual function of men in the lowest quartile of preoperative sexual function score (p = 0.15) but did have a significant beneficial effect on sexual function in the higher 3 quartiles (p = 0.04, p <0.01 and p <0.01, respectively). Alternatively, nerve sparing improved urinary function in men in the lowest quartile of baseline sexual function. CONCLUSIONS: Nerve sparing radical prostatectomy results in better sexual function outcomes than no nerve sparing in most men except those with little baseline function. Urinary function was positively impacted in all men. Men who are suitable candidates for nerve preservation may benefit from nerve sparing surgery. Poorer baseline sexual function should not exclude these men from such surgery.
SN - 1527-3792
UR - https://www.unboundmedicine.com/medline/citation/23410984/Men_with_low_preoperative_sexual_function_may_benefit_from_nerve_sparing_radical_prostatectomy_
L2 - https://www.jurology.com/doi/10.1016/j.juro.2013.02.008?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed
DB - PRIME
DP - Unbound Medicine
ER -