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Men with low preoperative sexual function may benefit from nerve sparing radical prostatectomy.
J Urol. 2013 Sep; 190(3):981-6.JU

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.

Authors+Show Affiliations

Department of Urology, UCSF Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California 94143-1695, USA. HarrisCR@urology.ucsf.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23410984

Citation

Harris, Catherine R., et al. "Men With Low Preoperative Sexual Function May Benefit From Nerve Sparing Radical Prostatectomy." The Journal of Urology, vol. 190, no. 3, 2013, pp. 981-6.
Harris CR, Punnen S, Carroll PR. Men with low preoperative sexual function may benefit from nerve sparing radical prostatectomy. J Urol. 2013;190(3):981-6.
Harris, C. R., Punnen, S., & Carroll, P. R. (2013). Men with low preoperative sexual function may benefit from nerve sparing radical prostatectomy. The Journal of Urology, 190(3), 981-6. https://doi.org/10.1016/j.juro.2013.02.008
Harris CR, Punnen S, Carroll PR. Men With Low Preoperative Sexual Function May Benefit From Nerve Sparing Radical Prostatectomy. J Urol. 2013;190(3):981-6. PubMed PMID: 23410984.
* Article titles in AMA citation format should be in sentence-case
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&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -