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

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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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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 › Urology › 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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