1008 MEN WITH LOW PREOPERATIVE SEXUAL FUNCTION MAY BENEFIT FROM NERVE-SPARING RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized (IV)1 Apr 20131008 MEN WITH LOW PREOPERATIVE SEXUAL FUNCTION MAY BENEFIT FROM NERVE-SPARING RADICAL PROSTATECTOMY Catherine Harris, Sanoj Punnen, and Peter Carroll Catherine HarrisCatherine Harris San Francisco, CA More articles by this author , Sanoj PunnenSanoj Punnen San Francisco, CA More articles by this author , and Peter CarrollPeter Carroll San Francisco, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.592AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The benefits of nerve-sparing radical prostatectomy (RP) for post-operative sexual function are well known, however, it is unclear whether nerve-sparing has a clear benefit in men with poor pretreatment sexual function. The objective of this study was to assess the effect of nerve-sparing radical prostatectomy on urinary and sexual function in men at various levels of pretreatment sexual function with a specific focus on men with poor function prior to surgery. METHODS Men within the CaPSURE database who underwent RP and had baseline and 2 year post-treatment UCLA Prostate Cancer Index (PCI) sexual and urinary function scores were selected for the study cohort. The degree of nerve-sparing was categorized as either complete bilateral, unilateral/partial, or no nerve-sparing, and the level of pre-treatment sexual function was divided into quartiles. The cohort was divided into subgroups of nerve-sparing technique and pre-treatment sexual function. Adjusted means of sexual function (SF) and urinary function (UF) within subgroups were calculated and the differences between means were tested using analysis of covariance. A test of interaction was performed between preoperative SF and degree of nerve-sparing on postoperative SF and UF scores. RESULTS 1,322 patients met the inclusion criteria. Median patient age was 61 (range 41-79). Bilateral, unilateral, and no nerve-sparing were performed in 899, 200 and 223 men, respectively. The effects of nerve-sparing on SF differed between the quartiles of pre-RP SF (p-value <0.01). Nerve-sparing did not have an effect on SF among men in the lowest quartile of pre-RP SF score (p=0.15), but had a significant benefit on SF in the higher three quartiles (p=0.04, p<0.01, p<0.01, respectively). Alternatively, nerve-sparing improved UF in men in the lowest quartile of baseline SF. CONCLUSIONS Nerve-sparing RP improves SF in most men with the exception of those with little/no baseline function. However, UF was positively impacted by nerve-sparing in these men. Men who are suitable candidates for nerve preservation based on the risk of extra capsular extension may benefit from nerve-sparing surgery. Poorer baseline sexual function should not exclude them from such surgery. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e414 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Catherine Harris San Francisco, CA More articles by this author Sanoj Punnen San Francisco, CA More articles by this author Peter Carroll San Francisco, CA More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...