НачалоЗа лекариErectile function and overall satisfaction 12 months after radical retropubic prostatectomy

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Stoykov B.A. 1 , Kolev N.H. 1 , Genov P. 1 , Dunev V.R. 1 , Kotsev R.P. 1 , Tonchev P.T. 2 , Vanov A. 1 , Atanasov J.A. 1

1Medical University Hospital, Dept. of Urology, Pleven, Bulgaria, 2Medical University Hospital, Dept. of Surgery, Pleven, Bulgaria

Introduction & Objectives: Erectile dysfunction occurs in 25-75% of men undergoing radical retropubic prostatectomy (RRP). This study aims to assess by erectile function (EF) and overall satisfaction domains of the international index of erectile function (IIEF), how EF influences the overall satisfaction (OS) in patients 12 months after RRP.

Materials & Methods: For the period from January 2013 to June 2016 in the Urology Clinic of the University Hospital "Dr. Georgi Stranski" - Pleven, 176 patients were operated with RRP. All patients answered the following questions: 1. Over the past 4 weeks, how often were you able to get an erection during sexual activity? 2. Over the past 4 weeks, when you had erections with sexual stimulation, how often were your erections hard enough for penetration? 3. Over the past 4 weeks, when you attempted sexual intercourse, how often were you able to penetrate (enter) your partner? 4. Over the past 4 weeks, during sexual intercourse, how often were you able to maintain your erection after you had penetrated your partner? 5. Over the past 4 weeks, during sexual intercourse, how difficult was it to maintain your erection to completion of intercourse? 13. Over the past 4 weeks, how satisfied have you been with you overall sex life? 14. Over the past 4 weeks, how satisfied have you been with your sexual relationship with your partner? 15. Over the past 4 weeks, how do you rate your confidence that you can get and keep your erection? Patients were considered to have a normal EF when IIEF-EF domain ≥26 points. Questions 13 and 14 concerned OS. According to the IIEF, OS is normal when IIEF-OS domain ≥9 points. The patients responded of these eight questions preoperatively and 12 months after surgery.

Results: Mean age of patients was 62.6 (±6.0) years. A total of 159 (90.3%) and 140 (79.5%) patients returned questionnaire pre- and postoperatively respectively. Questions 1,2,3,4,5,13,14 and 15 were answered by 135 (76.7%). Mean EF score pre- and postoperatively was 27.8 (± 1.2) and 10.2 (±1.1) respectively (p=0). A total of 102 (75.6%) of answered patients were potent preoperatively. A total of 19 (14.1%) of them were potent postoperatively (p < 0.00001). A total of 114 (84.4%) of answered patients were with OS (9-10 points) preoperatively. A total of 34 (25.2%) of them were with OS (9-10 points) postoperatively (p < 0.001).

Conclusions: Even though there is a severe reduction in erectile function 12 months postoperatively, the reduction in overall satisfaction is not so pronounced. This is important preoperative information to communicate to patients.

Eur Urol Suppl 2017; 16(11);e2918

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