ED Can Improve Years After Prostate Surgery

June 1, 2010 (San Francisco) -- If your sexual function's not what it used to be a year or two after prostate surgery, hang in there.

Men who are having trouble achieving erections after prostatectomy for prostate cancer can achieve improvement in function that's sufficient for sexual intercourse more than two years later, researchers say.

"The message to patients who have erectile dysfunction -- even those who have failed to have erections after surgery -- is that improvement does occur in a substantial number of men," says researcher Jeffrey Schiff, MD, a resident in urology at the State University of New York Downstate Medical Center in Brooklyn, New York.

Overall, one-third of men with marginal erectile function and one-fourth of men with serious erectile dysfunction 24 months after surgery continue to have improvement in erectile function on follow-up visits, he tells WebMD.

The findings were reported here at the 105th annual meeting of the American Urological Association (AUA).

Erectile Dysfunction After Prostate Surgery

For the study, Schiff and colleagues examined the medical records of 138 men who underwent radical prostatectomy and were evaluated for erectile function at follow-up visits to the doctor.

At each visit, the men were asked to rate their level of erectile function on a 5-level scale, where 1 corresponded to normal functioning and 5 to no erections.

Prior to surgery, two-thirds of the men said they had normal erectile functioning (level 1). The others put themselves at level 2, meaning "diminished erections, routinely sufficient for intercourse."

By two years later, 51 men had down-rated themselves to level 3, meaning "partial erections occasionally satisfactory for intercourse."

At subsequent follow-up visits, five (10%) of these men had normal functioning and 11 (22%) recovered enough to have intercourse, although they had diminished erections.

And 87 men said they had level 4 or level 5 erections, corresponding to partial erections not sufficient for intercourse or no erections, respectively, two years after surgery.

Of these men, one (1.1%) recovered normal (level 1) erections and nine (10%) recovered diminished erections, routinely sufficient for intercourse. Eleven (13%) recovered partial erections occasionally satisfactory for intercourse.

After about three years, though, men with the most severe erectile dysfunction showed almost no improvement, Schiff says. But men who had partial erections that were occasionally sufficient for intercourse (level 2 or 3) continued to make progress for up to four years after surgery.

Many Took ED Drugs

"It's common for men to have erectile dysfunction after prostatectomy and this shows they shouldn't get discouraged if sexual functioning doesn't come back right away," says AUA spokesman Ira Sharlip, MD, of the University of California, San Francisco.

"Even after two years, many will still improve," he tells WebMD.

If confirmed, the findings should be taken into account by men considering penile implants, Sharlip says. "That's a big step, one you may not want to take if you don't have to."

One drawback of the study is that about half the men in the study who suffered erectile dysfunction said they took ED drugs like Viagra, says study head Farhang Rabbani, MD, associate professor of urology at Montefiore Medical Center.

"This was not a controlled experiment, so we don't know if these drugs were helpful in overcoming erectile dysfunction," he tells WebMD.

This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.