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Erectile Function Recovery Rate after Radical Prostatectomy: A Meta-Analysis
Open accessAbstract
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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“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]
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“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]
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“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]
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“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]
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Metadata
- 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.
- 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
- 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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