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Predicting erectile function outcome in men after radical prostatectomy for prostate cancer
2012-01-21
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To identify the reported rates of potency after prostatectomy in the recent literature for men without preoperative erectile dysfunction (ED) and to develop a statistical model for predicting the expected potency after prostatectomy.
A Medline search was conducted with the keywords 'potency' and 'prostatectomy' from 2003 to 2009. In total, 33 studies in the English language reporting pre- and postoperative erectile function were identified. Data from studies reporting outcome after open, laparoscopic and robot-assisted prostatectomy were analyzed separately. Only data obtained from potent men before surgery were included in the analysis.
In potent men before surgery, the main predictors of post-treatment erectile function are age and time after treatment. The cumulative range of potency rates at 48 months for all ages (45-75 years) was 49-74% for open, 58-74% for laparoscopic and 60-100% for robotic prostatectomy. The predicted outcome differs by type of operation and patient age.
Men aged < 60 years have a significant likelihood of regaining erectile function after radical prostatectomy. The reported statistical model provides a reliable estimation of erectile function outcome after prostatectomy for men with localized prostate cancer and intact erectile function.