Importancia de la rehabilitación precoz de los cuerpos cavernosos tras prostatectomía radical

Abstract

ObjectivesPrimary: to evaluate the importance of early rehabilitation of the corpus cavernosum on erectile function after radical prostatectomy. Secondary: to analyse the factors associated with better response. Material and methodRetrospective study in patients treated with intracavernous injections after radical prostatectomy between 1 January 2006 and 31 December 2008. We included patients lacking a history of erectile dysfunction prior to surgery, not responding to phosphodiesterase-5 inhibitors. All patients underwent colour echo-doppler after injection of prostaglandin E1 10-20mg. The outcomes of these 2 groups were then compared according to how early rehabilitation began after surgery (early, <6 months, or late, >6 months). ResultsThere were 82 patients included in the study. In the multivariate analysis, predictive factors of good response to treatment were: early onset of rehabilitation (OR: 0.06; 95% CI: 0.014-0.26), higher peak systolic velocity during the test (OR: 1.01; 95% CI: 1.01-1.1) and favourable histopathological stage (OR: 0.15; 95% CI 95%: 0.036-0.6). The colour echo-doppler procedure after prostaglandin E1 injection showed abnormal values more frequently in the late-onset than in the early group (89.5% [n=34] vs. 65.9% [n=29]; P=.01). Corporal veno-occlusive dysfunction was presented by 40.2% (n=33) of subjects, with the late-onset group presenting higher values (5.53±1.4cm/sec) than the early group (4.75±1.03cm/sec) (P=.005). The presence of functional erections at 18 months’ follow-up was higher in the early onset group (P<.001). ConclusionsAccording to this study, early erectile dysfunction rehabilitation after radical prostatectomy achieves better results than late rehabilitation in patients.