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Back to Baseline: Erectile Function Recovery After Radical Prostatectomy from the Patients' Perspective
Open accessAbstract
Introduction: A variety of erectile function recovery (EFR) rates are reported post-radical prostatectomy (RP), with some suggesting EFR rates over 90% [1]. Clinical experience suggests that patients view EFR as getting back to their baseline (BTB) erectile functioning (EF) without the use of medication. Aim: This study explores EFR defined as BTB. Method: Men pre-RP and 24 months post-RP completed the Erectile Function Domain (EFD) of the International Index of Erectile Function and one question on phosphodiesterase type 5 inhibitor (PDE5i) use. Men using a PDE5i at baseline were excluded. Main Outcome Measures: At 24 m, “back to baseline” was defined as achieving the baseline EFD score (within 1 point or higher). Analyses included descriptive statistics, chi-square, and logistic regression. Results: One hundred eighty men had an average age at RP of 59 (SD = 7) years. When including men who were using a PDE5i at 24 months, 43% (N = 78, 95% CI: 36–51%) returned BTB. When considering BTB without the use of a PDE5i, 22% (N = 39, 95% CI: 16% to 28%) returned BTB. When focusing on a subset of men with baseline EFD ≥ 24 (N = 132), 36% (N = 47, 95% CI: 28% to 44%) returned BTB at 24 months using a PDE5i and 16% (N = 21, 95% CI: 11% to 23%) without the use of a PDE5i. For this group, there was a significant difference by age (<60 years, 23% vs. ≥60 years, 4%, P < 0.001), which remained a significant predictor (OR = 6.25, 95% CI: 1.88 to 50, P < 0.001) in multivariable analysis. Conclusions: Twenty-two percent of the entire sample and 16% of the men with functional (EFD ≥ 24) baseline erections returned to BTB EF without the use of medication. Only 4% of men who were ≥60 years old with functional erections pre-surgery achieved BTB EF. Although gaining partial EF is also important, men pre-RP should be educated on EFR and the chance of “back to baseline” EF.
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“In fact, only 16% of men undergoing a RP will regain their pre-surgery level of erectile functioning (6).”
From Men's experience with penile rehabilitation following radical prostatectomy: a qualitative study with the goal of informing a therapeutic intervention. (2015) · cites this paper as [6]
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Cites
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Erectile Function Recovery Rate after Radical Prostatectomy: A Meta-Analysis
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Montorsi, F., Brock, G. B., Stolzenburg, J., Mulhall, J. P., Moncada, I., PATEL, H. R. H., Chevallier, D., Krajka, K., Henneges, C., Dickson, R. A., et al. (2013) · European Urology · doi:10.1016/j.eururo.2013.09.051 · Cited by 251
Self-citationSexual dysfunction and infertility as late effects of cancer treatment
Schover, L. R., van der Kaaij, M. A. E., van Dorst, E. B. L., Creutzberg, C. L., Huyghe, É., & Kiserud, C. E. (2014) · European Journal of Cancer Supplements · doi:10.1016/j.ejcsup.2014.03.004 · Cited by 234
Erectile dysfunction after radical prostatectomy
Emanu, J. C., Avildsen, I. K., & Nelson, C. J. (2016) · Current Opinion in Supportive and Palliative Care · doi:10.1097/spc.0000000000000195 · Cited by 113
Self-citationPenile Rehabilitation Therapy Following Radical Prostatectomy: A Meta-Analysis
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Nerve-targeted probes for fluorescence-guided intraoperative imaging
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Metadata
- Authors
- Nelson, C. J., Scardino, P. T., Eastham, J. A., & Mulhall, J. P.
- Affiliations
- Memorial Sloan Kettering Cancer Center (US)
- Corresponding author
- Nelson, Christian J.
- Venue
- The Journal of Sexual Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-06-01
- Volume
- 10
- Issue
- 6
- Pages
- 1636-1643
- ISSN
- 1743-6095 (ISSN-L)
- 1743-6109
- PMC
- PMC4742368
- OpenAlex
- W1907014307
- Cited by
- 101
- References
- 24
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 7 · 2023: 5 · 2022: 5 · 2021: 10 · 2020: 14 · 2019: 6 · 2018: 9 · 2017: 10 · 2016: 9 · 2015: 10 · 2014: 9 · 2013: 1
- FWCI
- 6.84
- 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)
- PubMed Central (acceptedVersion)
- Funders
- Sidney Kimmel Center for Prostate and Urologic Cancers
- National Cancer Institute (R21CA149536)
- 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, prostate cancer, phosphodiesterase-5 inhibitors, International Index of Erectile Function, patient perspectives, age as predictor, erectile dysfunction
- MeSH terms
- Aged, Humans, Erectile Dysfunction, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Patient Education as Topic, Patients, Penile Erection, Prostatectomy, Prostatic Neoplasms, Surveys and Questionnaires, Time Factors, Chi-Square Distribution, Logistic Models, Odds Ratio, Recovery of Function, Phosphodiesterase 5 Inhibitors
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