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MINERVA UROLOGICA E NEFROLOGICA
A Journal on Nephrology and Urology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,536
Minerva Urologica e Nefrologica 2001 December;53(4):185-8
Postprostatectomy erectile dysfunction. Personal experience
Fischetti G., Cuzari S., De Martino P., Musy M., Valentini M. A., Leone P., Fraioli A., Mariani S.
Università degli Studi «La Sapienza» - Roma Dipartimento di Urologia «U. Bracci» Policlinico Umberto I
Background. To evaluate the frequency of erectile dysfunction in patients submitted to radical prostatectomy due to prostate carcinoma and to the possibility, with appropriate treatment, of restoring adequate erections for a satisfactory sexual activity.
Methods. Between 1996 and 2000, thirty-eight patients with prostate carcinoma have been submitted to radical prostatectomy. According to TNM classification upon diagnosis, thirty-three patients (87%) were stage pT2N0M0 and five patients (13%) stage pT3N0M0. Mean age of patients was 62.4 years (range 55-76). Mean follow-up was two years and seven months. Diagnosis of erectile dysfunction was made from personal history as well as that of the patient plus partner, and from nocturnal penile tumescence evaluation with Rigiscan.
Results. Eighteen patients (47%) presented erectile dysfunction as a complication 16 (89%) of whom showed no nocturnal reaction at the Rigiscan test, while in the remaining two (1%), one-two nocturnal erections of less than five minutes were obtained. Of the eighteen patients, 14 (78%) showed a positive response to treatment with intracavernous drug infusion (papaverine+Phentolamine+Alprostadil), whilst only one patient benefited from treatment with oral Sildenafil.
Conclusions. This study showed the high frequency (47%) of erectile dysfunction in patients submitted to radical prostatectomy as well as the need to perform radical “nerve-sparing” surgery (particularly in the neoplastic forms not involving the prostate capsule) which is useful not only for preserving erectile function but also on account of better response to oral Sildenafil treatment following the use of this technique.