Surveillance of sexual function after Robot-assisted laparoscopic radical prostatectomy

Abstract

ABSTRACT Introduction and Objectives Sexual dysfunction is one of the main factors that affects for quality of life (QOL) after prostatectomy. Previous research showed that sexual dysfunction after laparoscopic radical prostatectomy (LRP) was caused at 1 month, and refractory sexual dysfunction persisted for a long time. In recent years, robot-assisted laparoscopic radical prostatectomy (RALP) has been introduced at a large number of medical facilities. This time, we investigated change of sexual function after RALP using questionnaires related to sexual function. Materials and Methods Thirty-two patients were diagnosed localized prostate cancer and underwent RALP between January 2020 and June 2021 at our hospital. We investigated the change of sexual and voiding functions using International Index of Erectile Function (IIEF5), Expanded Prostate Cancer Index Composite (EPIC) at the time of diagnosis, 1, 3, 6, 12 month after RALP, and daily use numbers of urinary pad at 1, 3, 6, 12 month after RALP. Control was set at the time of diagnosis. This study was approved by the Ethics Committee of our facility (Approval No.3906-00). Results Patient age (median) was 67.5 (range 50-80) years old, body mass index (median) was 22.5 (range 17.4-28.7) kg/m2, and serum PSA (median) was 7.5 (range 4.0- 31.9) ng/ml at the time of diagnosis. Clinical stage T1c was accounted for 7 cases, T2a was 9 cases, T2b was 3 cases, T2c was 11 cases, and T3a was 2 cases. Fourteen patients (43.8%) underwent nerve-sparing RALP. IIEF5 and sexual function domain of EPIC showed deterioration at 1 month after RALP. However, sexual bother domain of EPIC showed not significant difference after RALP. The relevance between change of sexual function and nerve-sparing operation were not observed at our observation period. On the other hand, daily use numbers of urinary pad were significantly improved as time passed compared with that of at 1 month after RALP. The relevance between urinary continence and nerve-sparing operation were observed at 1 month after RALP. Conclusions Sexual dysfunction after RALP showed the same change as that after LRP. Besides, nerve-sparing operation might affect for urinary continence instead of sexual function. Disclosure Work supported by industry: no.