MP51-15 TIME FROM SURGERY TO URINARY CONTINENCE SIGNIFICANTLY INFLUENCES THE SUBSEQUENT RECOVERY OF ERECTILE FUNCTION IN PATIENTS TREATED WITH BILATERAL NERVE-SPARING RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized V1 Apr 2014MP51-15 TIME FROM SURGERY TO URINARY CONTINENCE SIGNIFICANTLY INFLUENCES THE SUBSEQUENT RECOVERY OF ERECTILE FUNCTION IN PATIENTS TREATED WITH BILATERAL NERVE-SPARING RADICAL PROSTATECTOMY Giorgio Gandaglia, Firas Abdollah, Andrea Gallina, Paolo Dell'Oglio, Andrea Salonia, Vincenzo Scattoni, Niccolò Maria Passoni, Nicola Fossati, Damiano Vizziello, Pierre I. Karakiewicz, Maxine Sun, Shahrokh F. Shariat, Francesco Montorsi, and Alberto Briganti Giorgio GandagliaGiorgio Gandaglia More articles by this author , Firas AbdollahFiras Abdollah More articles by this author , Andrea GallinaAndrea Gallina More articles by this author , Paolo Dell'OglioPaolo Dell'Oglio More articles by this author , Andrea SaloniaAndrea Salonia More articles by this author , Vincenzo ScattoniVincenzo Scattoni More articles by this author , Niccolò Maria PassoniNiccolò Maria Passoni More articles by this author , Nicola FossatiNicola Fossati More articles by this author , Damiano VizzielloDamiano Vizziello More articles by this author , Pierre I. KarakiewiczPierre I. Karakiewicz More articles by this author , Maxine SunMaxine Sun More articles by this author , Shahrokh F. ShariatShahrokh F. Shariat More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Alberto BrigantiAlberto Briganti More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1671AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Time from surgery to patient evaluation represents an important predictor of subsequent erectile function (EF) recovery in prostate cancer (PCa) patients after nerve-sparing radical prostatectomy (NSRP). However, evidence is scarce regarding the role of time between urinary continence (UC) recovery on subsequent EF recovery after surgery. We hypothesized that the early UC recovery might be a reliable predictor of EF recovery after bilateral NSRP (BNSRP). Methods The study included 870 patients with PCa treated with BNSRP between January 2008 and July 2013 at a single institution. UC recovery was defined as being completely pad-free over a 24-hour period. The International Index of Erectile Function-Erectile Function Index (IIEF-EF) was used to evaluate EF after BNSRP. Postoperative EF recovery was defined as an IIEF-EF domain score ≥22. We focused our analyses on preoperatively fully potent patients (namely, IIEF-EF≥26; n=223). Cumulative survival estimates were used to generate conditional recovery rates assessed at 6-month intervals. Our analyses were repeated after stratifying patients according to age at surgery (≤65 vs. 66-70 vs. ≥71), CCI (0 vs. 1 vs. ≥2), and D’Amico risk group (low- vs. intermediate/high-risk). Multivariate Cox regression analyses (MVA) tested the relationship between early UC recovery (within 1 month after surgery) and EF recovery after adjusting for age at surgery, Charlson Comorbidity Index (CCI), and risk group. Results At a mean follow up of 43 months (median 40), the 1- and 2-year EF recovery rates were 54.9% and 64.5%, respectively. The 1- and 2-year UC recovery rates were 79.4 and 85.9%, respectively. In patients who were still incontinent at 1-, 6-, 12-, and 18-months after surgery, EF recovery rates in the following 6-month period substantially decreased as the time following surgery increased: 34.2, 31.6, 26, and 6.7%, respectively. Similar trends were observed after stratifying patients according to age at surgery, CCI, and risk group. In MVA, earlier UC was associated with 2-fold higher probability of EF recovery, after adjusting for confounders (P<0.001). Conclusions The time elapsed between BNSRP and UC recovery has a substantial impact on the subsequent probability of EF recovery. Since UC recovery precedes EF recovery in the vast majority of the cases, these observations might help provide clinicians better postoperative counseling and planning of therapeutic approaches aimed at the optimal recovery of EF. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e603 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Giorgio Gandaglia More articles by this author Firas Abdollah More articles by this author Andrea Gallina More articles by this author Paolo Dell'Oglio More articles by this author Andrea Salonia More articles by this author Vincenzo Scattoni More articles by this author Niccolò Maria Passoni More articles by this author Nicola Fossati More articles by this author Damiano Vizziello More articles by this author Pierre I. Karakiewicz More articles by this author Maxine Sun More articles by this author Shahrokh F. Shariat More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...