Erectile Function Recovery Rate after Radical Prostatectomy: A Meta-Analysis

Tal, Raanan; Alphs, Hannah H.; Krebs, Paul; Nelson, Christian J.; Mulhall, John P.

doi:10.1111/j.1743-6109.2009.01351.x

Cited by 235Sexual function and dysfunction studiesProstate Cancer Diagnosis and TreatmentUrinary Bladder and Prostate Research

Erectile Function Recovery Rate after Radical Prostatectomy: A Meta-Analysis

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Tal, Raanan, Alphs, Hannah H., Krebs, Paul, Nelson, Christian J., Mulhall, John P.·2009·The Journal of Sexual Medicine

DOI 10.1111/j.1743-6109.2009.01351.xPMC PMC4097184

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Abstract

Introduction: Erectile function recovery (EFR) rates after radical prostatectomy (RP) vary greatly based on a number of factors, such as erectile dysfunction (ED) definition, data acquisition means, time-point postsurgery, and population studied. Aim: To conduct a meta-analysis of carefully selected reports from the available literature to define the EFR rate post-RP. Main Outcome Measures: EFR rate after RP. Methods: An EMBASE and MEDLINE search was conducted for the time range 1985–2007. Articles were assessed blindly by strict inclusion criteria: report of EFR data post-RP, study population ≥50 patients, ≥1 year follow-up, nerve-sparing status declared, no presurgery ED, and no other prostate cancer therapy. Meta-analysis was conducted to determine the EFR rate and relative risks (RR) for dichotomous subgroups. Results: A total of 212 relevant studies were identified; only 22 (10%) met the inclusion criteria and were analyzed (9,965 RPs, EFR data: 4,983 subjects). Mean study population size: 226.5, standard deviation = 384.1 (range: 17–1,834). Overall EFR rate was 58%. Single center series publications (k = 19) reported a higher EFR rate compared with multicenter series publications (k = 3): 60% vs. 33%, RR = 1.82, P = 0.001. Studies reporting ≥18-month follow-up (k = 10) reported higher EFR rate vs. studies with <18-month follow-up (k = 12), 60% vs. 56%, RR = 1.07, P = 0.02. Open RP (k = 16) and laparoscopic RP (k = 4) had similar EFR (57% vs. 58%), while robot-assisted RP resulted in a higher EFR rate (k = 2), 73% compared with these other approaches, P = 0.001. Patients <60 years old had a higher EFR rate vs. patients ≥60 years, 77% vs. 61%, RR = 1.26, P = 0.001. Conclusions: These data indicate that most of the published literature does not meet strict criteria for reporting post-RP EFR. Single and multiple surgeon series have comparable EFR rates, but single center studies have a higher EFR. Younger men have higher EFR and no significant difference in EFR between ORP and LRP is evident.

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Up to 90% of men treated for prostate cancer will experience significant sexual side effects.
“However, despite advances in the effectiveness of PC treatment in eradicating cancer, up to 90% of men treated will experience significant sexual side effects.1,3”
From Preliminary Development of a Mindfulness-Based Group Therapy to Expand Couples’ Sexual Intimacy after Prostate Cancer: A Mixed Methods Approach (2021) · cites this paper as [1]
The Introduction reports that long-term erectile dysfunction after radical prostatectomy has been reported in approximately 14–90% of men. That supports the upper-end figure for this specific surgery and outcome, but not the claim as phrased for all men treated for prostate cancer or for sexual side effects generally. Page numbers are unavailable in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Side effects of prostate cancer treatments impact the sexual lives of men and their partners, including erectile dysfunction, climacturia, anorgasmia, urinary or fecal incontinence, penile shortening, and/or loss of sexual desire.
“Side effects of PC treatments impact the sexual lives of men and their partners, including erectile dysfunction, climacturia (loss of urine with ejaculation), anorgasmia (inability to reach orgasm), urinary or fecal incontinence, penile shortening, and/or loss of sexual desire.1,3, 4, 5, 6,8,12”
From Preliminary Development of a Mindfulness-Based Group Therapy to Expand Couples’ Sexual Intimacy after Prostate Cancer: A Mixed Methods Approach (2021) · cites this paper as [1]
The Introduction states that erectile dysfunction after radical prostatectomy can negatively affect men and their sexual partners, and it identifies urinary continence as a treatment outcome. It does not support the sentence’s other listed effects—climacturia, anorgasmia, fecal incontinence, penile shortening, or loss of sexual desire—or extend its findings beyond radical prostatectomy to prostate cancer treatments generally. The supplied copy gives no page numbers for these passages. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Following prostate cancer treatments, sexual functioning and satisfaction sharply decline.
“Following PC treatments, sexual functioning and satisfaction sharply decline.1,2,14”
From Preliminary Development of a Mindfulness-Based Group Therapy to Expand Couples’ Sexual Intimacy after Prostate Cancer: A Mixed Methods Approach (2021) · cites this paper as [1]
The Introduction (page not available) reports long-term erectile dysfunction after radical prostatectomy, supporting a decline in one aspect of sexual functioning. The paper addresses surgery rather than prostate cancer treatments generally, and the cited passages do not establish a sharp decline in sexual satisfaction. (LLM, conf=0.88)
Experimental — accuracy not yet measured
PDE5 inhibitors have variable effectiveness for prostate cancer survivors.
“However, PDE5is have variable effectiveness for PC survivors,1,16”
From Preliminary Development of a Mindfulness-Based Group Therapy to Expand Couples’ Sexual Intimacy after Prostate Cancer: A Mixed Methods Approach (2021) · cites this paper as [1]
The Discussion reports wide variation in erectile-function recovery after radical prostatectomy and notes that some studies used erectogenic therapy. It also says those studies did not detail the therapy’s impact on their results. Searches for PDE5 inhibitors and treatment response found no passage assessing whether PDE5 inhibitors have variable effectiveness for prostate cancer survivors. (LLM, conf=0.75)
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Original Research—Men’s Sexual Health: Orgasmic Dysfunction After Open Radical Prostatectomy: Clinical Correlates and Prognostic Factors
Dubbelman, Y. D., Wildhagen, M. F., Schröder, F., Bangma, C., & Dohle, G. R. (2009) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2009.01567.x · Cited by 53 · see citing works
Prostate cancer survivorship: a review of erectile dysfunction and penile rehabilitation after prostate cancer therapy
Chung, E., & Gillman, M. (2014) · The Medical Journal of Australia · doi:10.5694/mja13.11028 · Cited by 53 · see citing works
Rapid Determination of Thiabendazole Pesticides in Rape by Surface Enhanced Raman Spectroscopy
Lin, L., Dong, T., Nie, P., Qu, F., He, Y., Chu, B., & Xiao, S. (2018) · Sensors · doi:10.3390/s18041082 · Cited by 49 · see citing works
Prevalence and Predicting Factors for Commonly Neglected Sexual Side Effects to External-Beam Radiation Therapy for Prostate Cancer
Frey, A., Pedersen, C. K., Lindberg, H., Bisbjerg, R., Sønksen, J. O. R., & Fode, M. M. (2017) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2017.01.015 · Cited by 47 · see citing works
Effect of androgen deprivation therapy on sexual function and bother in men with prostate cancer: a controlled comparison
Donovan, K. A., Gonzalez, B. D., Nelson, A. M., Fishman, M. N., Zachariah, B., & Jacobsen, P. B. (2018) · Psycho-Oncology · doi:10.1002/pon.4463 · Cited by 46 · see citing works
Subjective Characterization of Nerve Sparing Predicts Recovery of Erectile Function After Radical Prostatectomy: Defining the Utility of a Nerve Sparing Grading System
Moskovic, D. J., Alphs, H. H., Nelson, C. J., Rabbani, F., Eastham, J. A., Touijer, K. A., Guillonneau, B. D., Scardino, P. T., & Mulhall, J. P. (2010) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.01972.x · Cited by 45 · see citing works
Self-citation
Choosing the Best Candidates for Penile Rehabilitation After Bilateral Nerve-Sparing Radical Prostatectomy
Briganti, A., Trapani, E. D., Abdollah, F., Andrea Gallina, A., Suardi, N. R., Umberto Capitanio, A., Tutolo, M., Passoni, N. M., Salonia, A., DiGirolamo, V., et al. (2011) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2011.02580.x · Cited by 44 · see citing works
The 2018 Revision to the Process of Care Model for Management of Erectile Dysfunction
Mulhall, J. P., Giraldi, A. G. E., Hackett, G. I., Hellstrom, W. J. G., Jannini, E. A., Aurioles, E. R., Trost, L. W., & Hassan, T. A. (2018) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2018.05.021 · Cited by 43 · see citing works
Self-citation
NeuroSAFE in radical prostatectomy increases the rate of nerve‐sparing surgery without affecting oncological outcome
van der Slot, M. A., den Bakker, M. A., Tan, T., Remmers, S., Busstra, M. B., Gan, M., Klaver, S. O., RIETBERGEN, J. B. W., Kweldam, C. F., Kliffen, M., et al. (2022) · British Journal of Urology · doi:10.1111/bju.15771 · Cited by 41 · see citing works
Sexual Function in Elderly Men Receiving Androgen Deprivation Therapy (ADT)
Fode, M. M., & Sønksen, J. (2013) · Sexual Medicine Reviews · doi:10.1002/smrj.17 · Cited by 40 · see citing works
Sildenafil Attenuates Inflammation and Oxidative Stress in Pelvic Ganglia Neurons after Bilateral Cavernosal Nerve Damage
Garcia, L. A., Hlaing, S. M., Gutierrez, R., Sanchez, M., Kovanecz, I., Artaza, J., & Ferrini, M. G. (2014) · International Journal of Molecular Sciences · doi:10.3390/ijms151017204 · Cited by 40 · see citing works
Inter-observer variability of cribriform architecture and percent Gleason pattern 4 in prostate cancer: relation to clinical outcome
van der Slot, M. A., Hollemans, E., den Bakker, M. A., Hoedemaeker, R. F., Kliffen, M., Budel, L. M., Goemaere, N. N. T., & van Leenders, G. J. L. H. (2020) · Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin · doi:10.1007/s00428-020-02902-9 · Cited by 39 · see citing works
Patient Satisfaction and Regret After Robot-assisted Radical Prostatectomy: A Decision Regret Analysis
Lindsay, J., Uribe, S., Moschonas, D., Pavlakis, P. A., Perry, M. J. A., Patil, K., & Kusuma, V. R. M. (2020) · Urology · doi:10.1016/j.urology.2020.12.015 · Cited by 38 · see citing works
Effectiveness of physiotherapy interventions for improving erectile function and climacturia in men after prostatectomy: a systematic review and meta-analysis of randomized controlled trials
Kannan, P., Winser, S. J., Ho, L., Hei, L. C., Kin, L. C., Agnieszka, G. E., & Jeffrey, L. H. (2019) · Clinical Rehabilitation · doi:10.1177/0269215519840392 · Cited by 37 · see citing works
The Evolution of Orgasmic Pain (Dysorgasmia) Following Radical Prostatectomy
Matsushita, K., Tal, R., & Mulhall, J. P. (2012) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2012.02699.x · Cited by 37 · see citing works
Self-citation
Men's Sexual and Relational Adaptations to Erectile Dysfunction After Prostate Cancer Treatment
Wassersug, R. J., Westle, A., & Dowsett, G. W. (2016) · International Journal of Sexual Health · doi:10.1080/19317611.2016.1204403 · Cited by 37 · see citing works
Prevention and management of post prostatectomy erectile dysfunction.
Salonia, A., Castagna, G., Capogrosso, P., Castiglione, F., Briganti, A., & Montorsi, F. (2015) · PubMed Central · doi:10.3978/j.issn.2223-4683.2013.09.10 · Cited by 36 · see citing works
Is a return to baseline sexual function possible? An analysis of sexual function outcomes following laparoscopic radical prostatectomy
Levinson, A. W., Lavery, H. J., Ward, N. T., Su, L.-M., & Pavlovich, C. P. (2010) · World Journal of Urology · doi:10.1007/s00345-010-0616-5 · Cited by 36 · see citing works
Erectile Function Outcome After Bilateral Nerve Sparing Radical Prostatectomy: Which Patients May Be Left Untreated?
Andrea Gallina, A., Ferrari, M., Suardi, N. R., Umberto Capitanio, A., Abdollah, F., Tutolo, M., Bianchi, M., Saccà, A., Salonia, A., Rigatti, P., et al. (2012) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2011.02622.x · Cited by 36 · see citing works
Defining the impact of vascular risk factors on erectile function recovery after radical prostatectomy
Telöken, P., Nelson, C. J., Karellas, M., Stasi, J. P., Eastham, J. A., Scardino, P. T., & Mulhall, J. P. (2012) · British Journal of Urology · doi:10.1111/j.1464-410x.2012.11321.x · Cited by 36 · see citing works
Self-citation
Confocal laser microscopy for assessment of surgical margins during radical prostatectomy
Baas, D. J. H., Vreuls, W., Sedelaar, J. P. M., Vrijhof, H. J. E. J., Hoekstra, R. J., Zomer, S. F., van Leenders, G. J. L. H., van Basten, J. A., & Somford, D. M. (2022) · British Journal of Urology · doi:10.1111/bju.15938 · Cited by 35 · see citing works
Communication and Intimacy-Enhancing Interventions for Men Diagnosed with Prostate Cancer and Their Partners
Nelson, C. J., & Kenowitz, J. (2013) · The Journal of Sexual Medicine · doi:10.1111/jsm.12049 · Cited by 35 · see citing works
Self-citation
Recovery of Baseline Erectile Function in Men Following Radical Prostatectomy for High-Risk Prostate Cancer: A Prospective Analysis Using Validated Measures
Sridhar, A. N., Cathcart, P. J., Yap, T., Hines, J. E. W., Nathan, S., Briggs, T. P., Kelly, J. D., & Minhas, S. (2016) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2016.01.005 · Cited by 35 · see citing works
A Double-Blind, Randomized Trial on the Efficacy and Safety of Hyperbaric Oxygenation Therapy in the Preservation of Erectile Function after Radical Prostatectomy
Chiles, K. A., Staff, I., Johnson-Arbor, K. K., Champagne, A., McLaughlin, T., & Graydon, R. J. (2017) · The Journal of Urology · doi:10.1016/j.juro.2017.10.016 · Cited by 34 · see citing works
Depressive Symptoms and Low Sexual Desire after Radical Prostatectomy: Early and Long-Term Outcomes in a Real-Life Setting
Boeri, L., Capogrosso, P., Ventimiglia, E., Cazzaniga, W., Pederzoli, F., Gandaglia, G., Finocchio, N., Dehò, F., Briganti, A., Montanari, E., et al. (2017) · The Journal of Urology · doi:10.1016/j.juro.2017.08.104 · Cited by 34 · see citing works
Erectile Dysfunction A Prospective Randomized Placebo-Controlled Study Evaluating the Effect of Low-Intensity Extracorporeal Shockwave Therapy (LI-ESWT) in Men With Erectile Dysfunction Following Radical Prostatectomy
Ladegaard, P. B. J., Mortensen, J., Skov-Jeppesen, S. M., & Lund, L. C. (2021) · Sexual Medicine · doi:10.1016/j.esxm.2021.100338 · Cited by 32 · see citing works
Intraoperative assessment and reporting of radical prostatectomy specimens to guide nerve‐sparing surgery in prostate cancer patients (NeuroSAFE)
van der Slot, M. A., den Bakker, M. A., Klaver, S. O., Kliffen, M., Busstra, M. B., RIETBERGEN, J. B. W., Gan, M., Hamoen, K. E., Budel, L. M., Goemaere, N. N. T., et al. (2020) · Histopathology · doi:10.1111/his.14184 · Cited by 32 · see citing works
Long‐term follow‐up of treatment of erectile dysfunction after radical prostatectomy using nerve grafts and end‐to‐side somatic‐autonomic neurorraphy: a new technique
Trindade, J. C. S., Viterbo, F., Trindade, A. P., Fávaro, W. J., & Trindade-Filho, J. C. S. (2017) · British Journal of Urology · doi:10.1111/bju.13772 · Cited by 31 · see citing works
International Continence Society (ICS) report on the terminology for sexual health in men with lower urinary tract (LUT) and pelvic floor (PF) dysfunction
Kocjancic, E., Chung, E., Garzón, J. H. Á., Haylen, B. T., Iacovelli, V., Jaunarena, J. H., Locke, J. A., Millman, A. L., Nahon, I., Ohlander, S. J., et al. (2022) · Neurourology and Urodynamics · doi:10.1002/nau.24846 · Cited by 35 · see citing works
Intra-Abdominal Reservoir Placement During Penile Prosthesis Surgery in Post-Robotically Assisted Laparoscopic Radical Prostatectomy Patients: A Case Report and Practical Considerations
Sadeghi‐Nejad, H., Munarriz, R. M., & Shah, N. (2011) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2011.02229.x · Cited by 31 · see citing works
Erection Hardness Score for the Evaluation of Erectile Dysfunction: Further Psychometric Assessment in Patients Treated by Intracavernous Prostaglandins Injections after Radical Prostatectomy
Parisot, J., Yiou, R., Salomon, L., TAILLE, A. D. L., Lingombet, O., & Audureau, É. (2014) · The Journal of Sexual Medicine · doi:10.1111/jsm.12584 · Cited by 30 · see citing works
Comparison of Penile Size and Erectile Function after High-intensity Focused Ultrasound and Targeted Cryoablation for Localized Prostate Cancer: A Prospective Pilot Study
Ling, L., Lin, Z., Yang, M., Gao, X., Xia, T., & Ding, T. (2010) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.01751.x · Cited by 29 · see citing works
Penile Rehabilitation After Prostate Cancer Treatment: Outcomes and Practical Algorithm
Mazzola, C. R., & Mulhall, J. P. (2011) · Urologic Clinics of North America · doi:10.1016/j.ucl.2011.03.002 · Cited by 29 · see citing works
Self-citation
The Female Factor: Predicting Compliance with a Post-Prostatectomy Erectile Preservation Program
Moskovic, D. J., Mohamed, O., Sathyamoorthy, K., Miles, B. J., Link, R. E., Lipshultz, L. I., & Khera, M. (2010) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.02014.x · Cited by 28 · see citing works
Infrequent Reservoir-Related Complications of Urologic Prosthetics: A Case Series and Literature Review
Cui, T., Terlecki, R. P., & Mirzazadeh, M. (2015) · Sexual Medicine · doi:10.1002/sm2.85 · Cited by 28 · see citing works
Effect of icariin in combination with daily sildenafil on penile atrophy and erectile dysfunction in a rat model of bilateral cavernous nerves injury
Xu, Y., Xin, H., Wu, Y., Guan, R., Lei, H., Fu, X., Xin, Z., & Yang, Y. (2017) · Andrology · doi:10.1111/andr.12341 · Cited by 28 · see citing works
Low‐intensity pulsed ultrasound ameliorates erectile dysfunction induced by bilateral cavernous nerve injury through enhancing Schwann cell‐mediated cavernous nerve regeneration
Li, Z., Ye, K., Yin, Y., Zhou, J., Li, D., Gan, Y., Peng, D., Zhao, L., Xiao, M., Zhou, Y., et al. (2023) · Andrology · doi:10.1111/andr.13406 · Cited by 27 · see citing works
Nitrergic Function is Lost but Endothelial Function Is Preserved in the Corpus Cavernosum and Penile Resistance Arteries of Men After Radical Prostatectomy
Martínez‐Salamanca, J. I., Fuente, J. M. L., Fernández, A., Martínez-Salamanca, E., Pepe-Cardoso, A. J., Carballido, J., & Angulo, J. (2014) · The Journal of Sexual Medicine · doi:10.1111/jsm.12801 · Cited by 27 · see citing works
Comprehensive Analysis of Sexual Function Outcome in Prostate Cancer Patients After Robot-Assisted Radical Prostatectomy
Woo, S. H., Kang, D. I., Ha, Y., Salmasi, A., Kim, J. H., Lee, D.-H., Kim, W., & Kim, I. Y. (2013) · Journal of Endourology · doi:10.1089/end.2013.0304 · Cited by 27 · see citing works
Postoperative Orgasmic Function Increases over Time in Patients Undergoing Nerve-Sparing Radical Prostatectomy
Salonia, A., Andrea Gallina, A., Briganti, A., Colombo, R., Bertini, R., Pozzo, L. D., Zanni, G. E., Saccà, A., Rocchini, L., Guazzoni, G. F., et al. (2009) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2009.01518.x · Cited by 26 · see citing works
Tools for predicting patient-reported outcomes in prostate cancer patients undergoing radical prostatectomy: a systematic review of prognostic accuracy and validity
O’Callaghan, M. E., Raymond, E., Campbell, J. M., Vincent, A. D., Beckmann, K., Roder, D. M., Evans, S., McNeil, J. J., Millar, J. L., Zalcberg, J. R., et al. (2017) · Prostate Cancer and Prostatic Diseases · doi:10.1038/pcan.2017.28 · Cited by 26 · see citing works
Urinary Incontinence and Sexual Function After the Introduction of NeuroSAFE in Radical Prostatectomy for Prostate Cancer
van der Slot, M. A., Remmers, S., van Leenders, G. J. L. H., Busstra, M. B., Gan, M., Klaver, S. O., RIETBERGEN, J. B. W., den Bakker, M. A., Kweldam, C. F., Bangma, C. H., et al. (2023) · European Urology Focus · doi:10.1016/j.euf.2023.03.021 · Cited by 25 · see citing works
Erectile Function Recovery After Nerve-Sparing Radical Prostatectomy for Prostate Cancer: Is Back to Baseline Status Enough for Patient Satisfaction?
Rossi, M. S., Moschini, M., Bianchi, M., Gandaglia, G., Fossati, N., Dell’Oglio, P., Schiavina, R., Brunocilla, E., Farina, E., Picozzi, M., et al. (2016) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2016.02.160 · Cited by 25 · see citing works
Current status of penile rehabilitation after radical prostatectomy
Kim, J. H., & Lee, S. W. (2015) · Korean journal of urology · doi:10.4111/kju.2015.56.2.99 · Cited by 24 · see citing works
Erectile function recovery in patients after non‐nerve sparing radical prostatectomy
Krishnan, R., Katz, D. J., Nelson, C. J., & Mulhall, J. P. (2014) · Andrology · doi:10.1111/andr.282 · Cited by 24 · see citing works
Self-citation
Exosome Released From Schwann Cells May Be Involved in Microenergy Acoustic Pulse–Associated Cavernous Nerve Regeneration
Peng, D., Reed‐Maldonado, A. B., Zhou, F., Tan, Y. L., Yuan, H., Banie, L., Wang, G., Tang, Y., He, L., Lin, G., et al. (2020) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2020.05.018 · Cited by 24 · see citing works
Androgen deprivation therapy before radical prostatectomy is associated with poorer postoperative erectile function outcomes
Mazzola, C. R., Deveci, S., Heck, M. M., & Mulhall, J. P. (2011) · British Journal of Urology · doi:10.1111/j.1464-410x.2011.10728.x · Cited by 24 · see citing works
Self-citation
Predicting participation in and successful outcome of a penile rehabilitation programme using a phosphodiesterase type 5 inhibitor with a vacuum erection device after radical prostatectomy
Kimura, M., Caso, J., Bañez, L. L., Koontz, B. F., Gerber, L., Şenocak, Ç., Donatucci, C. F., Vujašković, Ž., Moul, J. W., & Polascik, T. J. (2012) · British Journal of Urology · doi:10.1111/j.1464-410x.2012.11168.x · Cited by 24 · see citing works
Management of erectile dysfunction following robot-assisted radical prostatectomy: a systematic review
Marchioni, M., Francesco, P. D., Castellucci, R., Papalia, R., Sarıkaya, S., Rivas, J. G., Schips, L., Scarpa, R. M., & Esperto, F. (2020) · Minerva Urologica e Nefrologica · doi:10.23736/s0393-2249.20.03780-7 · Cited by 23 · see citing works
Postprostatectomy erectile dysfunction: the role of penile rehabilitation.
DeFade, B., Carson, C. C., & Kennelly, M. (2011) · Europe PMC (PubMed Central) · Cited by 23 · see citing works
Efficacy of Low-Intensity Extracorporeal Shock Wave Treatment in Erectile Dysfunction Following Radical Prostatectomy: A Systematic Review and Meta-Analysis
Rho, B. Y., Kim, S. H., Ryu, J., Kang, D. H., Kim, J. W., & Chung, D. Y. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11102775 · Cited by 22 · see citing works
Extended Pelvic Lymph Node Dissection Does Not Affect Erectile Function Recovery in Patients Treated with Bilateral Nerve-Sparing Radical Prostatectomy
Gandaglia, G., Suardi, N. R., Andrea Gallina, A., Abdollah, F., Umberto Capitanio, A., Salonia, A., Colombo, R., Bianchi, M., Chun, F. K. ‐., Hansen, J., et al. (2012) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2012.02812.x · Cited by 21 · see citing works
Sexual Health Issues in Cancer Survivors
Falk, S. J., & Dizon, D. S. (2020) · Seminars in Oncology Nursing · doi:10.1016/j.soncn.2019.150981 · Cited by 21 · see citing works
Comprehensive approach for preserving cavernous nerves and erectile function after radical prostatectomy in the era of robotic surgery
Haga, N., Miyazaki, T., Tsubouchi, K., Okabe, Y., Shibayama, K., Emoto, D., Matsuoka, W., Maruta, H., Aoyagi, C., Matsuzaki, H., et al. (2021) · International Journal of Urology · doi:10.1111/iju.14491 · Cited by 21 · see citing works
Efficacy and Safety of Tadalafil 5 mg Once Daily for the Treatment of Erectile Dysfunction After Robot-Assisted Laparoscopic Radical Prostatectomy: A 2-Year Follow-Up
Kim, S., & Sung, G. T. (2018) · Sexual Medicine · doi:10.1016/j.esxm.2017.12.005 · Cited by 20 · see citing works
Sexual Dysfunction after Rectal Surgery: A Retrospective Study of Men without Disease Recurrence
Zugor, V., Miskovic, I., Lausen, B., Matzel, K. E., Hohenberger, W., Schreiber, M., Labanaris, A. P., Neuhuber, W., Witt, J. H., & Schott, G. E. (2010) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.01846.x · Cited by 21 · see citing works
α1A-Adrenergic Receptor Antagonism Improves Erectile and Cavernosal Responses in Rats with Cavernous Nerve Injury and Enhances Neurogenic Responses in Human Corpus Cavernosum from Patients with Erectile Dysfunction Secondary to Radical Prostatectomy
Martínez‐Salamanca, J. I., Fuente, J. M. L., Martínez-Salamanca, E., Fernández, A., Pepe-Cardoso, A. J., Louro, N., Carballido, J., & Angulo, J. (2016) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2016.10.005 · Cited by 20 · see citing works
Intraoperative frozen section monitoring during nerve-sparing radical prostatectomy: evaluation of partial secondary resection of neurovascular bundles and its effect on oncologic and functional outcome
Hatzichristodoulou, G., Wagenpfeil, S., Weirich, G., Autenrieth, M. E., Maurer, T., Thalgott, M. K., Horn, T. D., Heck, M. M., Herkommer, K., Gschwend, J. E., et al. (2015) · World Journal of Urology · doi:10.1007/s00345-015-1623-3 · Cited by 20 · see citing works
An update on emerging drugs for the treatment of erectile dysfunction
Milenković, U., Campbell, J. D., Roussel, E., & Albersen, M. (2018) · Expert Opinion on Emerging Drugs · doi:10.1080/14728214.2018.1552938 · Cited by 19 · see citing works
Role of inhibiting LIM-kinase2 in improving erectile function through suppression of corporal fibrosis in a rat model of cavernous nerve injury
Cho, M., Park, J., Cho, S., Park, K., Chai, J. S., Son, H., Kim, S.-W., & Paick, J. (2018) · Asian Journal of Andrology · doi:10.4103/aja.aja_82_17 · Cited by 19 · see citing works
Circulating Sex Hormones Play No Role in the Association Between Sexual Activity and the Risk of Prostate Cancer
Ahmadi, H., Allameh, F., Baradaran, N., Montaser‐Kouhsari, L., Bazargan‐Hejazi, S., Salem, S., Mehrsai, A., & Pourmand, G. (2010) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.02115.x · Cited by 19 · see citing works
Preliminary Development of a Mindfulness-Based Group Therapy to Expand Couples’ Sexual Intimacy after Prostate Cancer: A Mixed Methods Approach
Bossio, J. A., Higano, C. S., & Brotto, L. A. (2021) · Sexual Medicine · doi:10.1016/j.esxm.2020.100310 · Cited by 18 · see citing works
“However, despite advances in the effectiveness of PC treatment in eradicating cancer, up to 90% of men treated will experience significant sexual side effects.(1,3) These side effects negatively impact patient and partner quality of life (QoL), and for some men will impact their decision to undergo treatment at all.”
Background
Sexual health recovery for prostate cancer survivors: the proposed role of acceptance and mindfulness-based interventions
Bossio, J. A., Miller, F., O’Loughlin, J. I., & Brotto, L. A. (2019) · Sexual Medicine Reviews · doi:10.1016/j.sxmr.2019.03.001 · Cited by 18 · see citing works
Revision of Penile Prosthesis Surgery After Use of Penile Traction Therapy to Increase Erect Penile Length: Case Report and Review of the Literature
Moskovic, D. J., Pastuszak, A. W., Lipshultz, L. I., & Khera, M. (2010) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.02121.x · Cited by 18 · see citing works
REVIEW: Utilization of Pharmacotherapy for Erectile Dysfunction Following Treatment for Prostate Cancer
Prasad, M. M., Prasad, S. M., Hevelone, N. D., Gu, X., Weinberg, A. C., Lipsitz, S. R., Palapattu, G. S., & Hu, J. C. (2010) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2009.01644.x · Cited by 18 · see citing works
Udenafil Enhances the Recovery of Erectile Function and Ameliorates the Pathophysiological Consequences of Cavernous Nerve Resection
Lee, C., Shin, J.-H., Ahn, G.-J., Kang, K.-K., Ahn, B. O., & Yoo, M. (2010) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.01858.x · Cited by 18 · see citing works
Assessment of Return to Baseline Urinary and Sexual Function Following Primary Focal Cryotherapy for Nonmetastatic Prostate Cancer
Shah, T. T., Peters, M., Miah, S., Eldred‐Evans, D., Yap, T., Hosking‐Jervis, F., Dudderidge, T. J., Hindley, R. G., McCracken, S. R., Greene, D. R., et al. (2019) · European Urology Focus · doi:10.1016/j.euf.2019.09.004 · Cited by 18 · see citing works
A Retrospective Study of Erectile Function and Use of Erectile Aids in Prostate Cancer Patients After Radical Prostatectomy in Denmark
Haahr, M. K., Azawi, N., Andersen, L. G., Carlson, S., & Lund, L. C. (2017) · Sexual Medicine · doi:10.1016/j.esxm.2017.06.003 · Cited by 17 · see citing works
Sexual Quality of Life in Women Partnered with Men Using Intracavernous Alprostadil Injections after Radical Prostatectomy
Yiou, R., Ebrahiminia, V., Mouracadé, P., Lingombet, O., & Abbou, C. C. (2013) · The Journal of Sexual Medicine · doi:10.1111/jsm.12109 · Cited by 16 · see citing works
Erectile dysfunction and cancer: current perspective
Madan, R., Dracham, C. B., Khosla, D., Goyal, S., & Yadav, A. K. (2020) · Radiation Oncology Journal · doi:10.3857/roj.2020.00332 · Cited by 16 · see citing works
Patient satisfaction and decision regret in patients undergoing radical prostatectomy: a multicenter analysis
Guercio, A., Lombardo, R., Turchi, B., Romagnoli, M., Franco, A., D’Annunzio, S., Fusco, F., Pastore, A. L., Salhi, Y. A., Fuschi, A., et al. (2025) · International Urology and Nephrology · doi:10.1007/s11255-025-04510-5 · Cited by 15 · see citing works
The Use of Stromal Vascular Fraction in the Treatment of Male Sexual Dysfunction: A Review of Preclinical and Clinical Studies
Haney, N. M., Gabrielson, A. T., Kohn, T. P., & Hellstrom, W. J. G. (2018) · Sexual Medicine Reviews · doi:10.1016/j.sxmr.2018.04.001 · Cited by 15 · see citing works
Localized Prostate Cancer in Norway, the United States, and Spain: Between-Country Differences of Variables Before Treatment Among Patients Eligible for Curative Treatment
Storås, A. H., Sanda, M. G., Ferrer, M., Loge, J. H., Dahl, A. A., Steinsvik, E. A. S., Guedea, F., Cvancarova, M., & Fosså, S. D. (2014) · Clinical Genitourinary Cancer · doi:10.1016/j.clgc.2013.12.007 · Cited by 15 · see citing works
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ORIGINAL RESEARCH—ERECTILE DYSFUNCTION Erectile Function Recovery Rate after Radical Prostatectomy:
Tal, R., Alphs, H. H., Krebs, P. M., Nelson, C. J., & Mulhall, J. P. (2009)
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PD32-02 ERECTILE DYSFUNCTION CRITERIA OF 131,350 PATIENTS AFTER OPEN, LAPAROSCOPIC, AND ROBOTIC RADICAL PROSTATECTOMY
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Authors: Tal, R., Alphs, H. H., Krebs, P., Nelson, C. J., & Mulhall, J. P.
Affiliations: Memorial Sloan Kettering Cancer Center (US)
Corresponding author: Mulhall, John P.
ORCID: Krebs, Paul
Nelson, Christian J.
Mulhall, John P.
Venue: The Journal of Sexual Medicine
Publisher: Oxford University Press (OUP)
Published: 2009-09-01
Volume: 6
Issue: 9
Pages: 2538-2546
ISSN: 1743-6095 (ISSN-L)
1743-6109
DOI: 10.1111/j.1743-6109.2009.01351.x
PMC: PMC4097184
OpenAlex: W2056609863
Cited by: 235
References: 41
Citations by year: 2026: 9 · 2025: 13 · 2024: 13 · 2023: 14 · 2022: 10 · 2021: 8 · 2020: 11 · 2019: 10 · 2018: 12 · 2017: 20 · 2016: 20 · 2015: 21 · 2014: 16 · 2013: 18 · 2012: 9
FWCI: 1.64
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations: The Journal of Sexual Medicine (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: Sidney Kimmel Center for Prostate and Urologic Cancers
National Cancer Institute (P30CA008748, T32CA009461)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Diagnosis and Treatment
Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
Keywords: erectile function recovery, radical prostatectomy, erectile dysfunction, nerve-sparing surgery, robot-assisted radical prostatectomy, laparoscopic radical prostatectomy, open radical prostatectomy, follow-up duration, prostate cancer surgery outcomes, publication bias
MeSH terms: Aged, Humans, Male, Middle Aged, Penile Erection, Postoperative Complications, Prostatectomy, Risk, Risk Factors, Impotence, Vasculogenic

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Erectile Function Recovery Rate after Radical Prostatectomy: A Meta-Analysis

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