1681 BASELINE SEXUAL HEALTH INVENTORY FOR MEN (SHIM) PREDICTIVE OF ERECTILE FUNCTION FOLLOWING ROBOT-ASSISTED LAPAROSCOPIC PROSTATECTOMY (RALP)

Abstract

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Medical and Non-Surgical Therapy1 Apr 20111681 BASELINE SEXUAL HEALTH INVENTORY FOR MEN (SHIM) PREDICTIVE OF ERECTILE FUNCTION FOLLOWING ROBOT-ASSISTED LAPAROSCOPIC PROSTATECTOMY (RALP) Kurt Strom, Massimiliano Spaliviero, Xiao Gu, and Carson Wong Kurt StromKurt Strom Oklahoma City, OK More articles by this author , Massimiliano SpalivieroMassimiliano Spaliviero Oklahoma City, OK More articles by this author , Xiao GuXiao Gu Oklahoma City, OK More articles by this author , and Carson WongCarson Wong Oklahoma City, OK More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1835AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Preoperative erectile function and age are powerful predictors of erectile function following surgical treatment of clinically localized prostate cancer. We determine if baseline SHIM scores are predictive of erectile function following nerve-sparing RALP. METHODS Consecutive patients who underwent transperitoneal RALP by a single surgeon (CW) were reviewed. Using an anterior approach, a bladder neck sparing procedure was preferentially performed. Bilateral or unilateral nerve sparing prostatectomy was performed when appropriate. Penile rehabilitation [phosphodiesterase-5 (PDE-5) inhibitor and vacuum erection device (VED)] was offered to all patients. SHIM scores were obtained at baseline, 6 weeks and 3, 6, 9, 12, 15, 18, 21 and 24 months post surgery. RESULTS 219 consecutive patients were identified, of whom 204 (93.2%) underwent nerve sparing prostatectomy [185 (84.5%) bilateral; 19 (8.7%) unilateral] and 15 (6.8%) did not. Of those undergoing nerve sparing prostatectomy, 164/204 (80.3%) had post−surgery penile rehabilitation [phosphodiesterase−5 inhibitor ± vacuum erection device (VED)]. The mean baseline SHIM of patients with nerve sparing prostatectomy and penile rehabilitation was 16.4 ± 7.9. 92/164 (56.1%) patients had baseline SHIM < 21 (mean 11.2 ± 6.2) and 72/164 (43.9%) patients had baseline SHIM ≥ 21 (mean 23.9 ± 1.3), of whom 32 / 72 (44.4%) reported sexual potency post-surgery. In comparing these patient groups, SHIM postoperatively were similar until the 15 month follow-up interval, where the SHIM diverged significantly. Those with a preoperative SHIM ≥ 21 showed significantly greater improvement in their postoperative SHIM versus those with a preoperative SHIM < 21. CONCLUSIONS Preoperative SHIM is a useful tool in predicting postoperative erectile function in patients undergoing unilateral or bilateral nerve sparing RALP with penile rehabilitation therapy post surgery. Baseline 6 w 3 mo 6 mo 9 mo 12 mo 15 mo SHIM <21 12.5±5.8(92) 4.6±5.2(90) 5.7±5.8(79) 6.6±6.7(68) 7.8±7.4(48) 9.1±7.8(40) 7.8±8.3(31) SHIM ≥21 23.9±1.3(72) 3.7±5.0(58) 5.6±6.4(54) 7.4±6.8(45) 9.4±7.2(39) 12.1±8.5(30) 13.7±9.2(21) p-value <0.001 0.368 0.972 0.555 0.340 0.143 0.022 © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e676 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kurt Strom Oklahoma City, OK More articles by this author Massimiliano Spaliviero Oklahoma City, OK More articles by this author Xiao Gu Oklahoma City, OK More articles by this author Carson Wong Oklahoma City, OK More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...