НачалоЗа лекариBasic sexual function of patients candidates for bilateral nerve-sparing radical retropubic prostatectomy

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Stoykov B.A. , Kolev N.H. , Genov P. , Dunev V.R. , Kotsev R.P. , Vanov A. , Atanasov J.A. , Al-Shargabi F.

Medical University Hospital, Dept. of Urology, Pleven, Bulgaria

Introduction & Objectives: Necessity of preoperative evaluation of the sexual function in patients undergoing bilateral nerve sparing radical retropubic prostatectomy (BNSRRP) is bеing more emphasized because of the fact that in the last few years prostate cancer is more frequently diagnosed in young patients. The aim of our study is to make objective evaluation of the basic sexual function in patients with clinically localized prostate cancer which are candidates for BNSRRP, using internationally validated questionnaires. To find correlation on one hand between these questionnaires and the individual judgement of candidates and on the other hand between comorbidities of the patients and degree of erectile dysfunction (ED).

Materials & Methods: From the period January 2014 to March 2017 at the Urology clinic at "Dr.Georgi Stranski" university Hospital - Pleven, 64 patients opted BNSRRP and reported to have preserved erectile function (EF) and wish to maintain it post surgery. The inclusion criteria in the study were patients in stage T1c, Gleason score 6, life expectancy over 10 years and normal preoperative sexual function. The patient history and comorbidities were noted on the day of hospitalization. The subjective assessment of the patient's potency is compared with International Index of Erectile Function (IIEF).

 Results: According to the EF domain of the IIEF, baseline normal EF was assessed in 28 patient (44%). Twelve patients (18.8%) had mild ED, 9 patients (14.1%) had mild to moderate ED, 7 patients (10.9%) had moderate and 8 (12.5%) had severe ED. The results showed that a significant number of patients with clinically localized prostate cancer who were candidates for BNSRRP reported to be fully potent but actually had impaired EF preoperatively. There is also a pronounced correlation between concomitant diseases and EF.

Conclusions: Using the IIEF, we found that less than half of all subjects selected for bilateral nerve sparing radical retropubic prostatectomy have preserve sexual function preoperatively. This indicates that the majority of patients had impaired EF before surgery. This requires wider use of internationally validated questionnaires for a more accurate prognosis of postoperative sexual function. Last but not least, the results from these questionnaires may require a change in the operative technique and the treatment method used.

Eur Urol Suppl 2017; 16(11);e2917

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