Y. Kawanishi et al., Effect of radical retropubic prostatectomy on erectile function, evaluatedbefore and after surgery using colour Doppler ultrasonography and nocturnal penile tumescence monitoring, BJU INT, 88(3), 2001, pp. 244-247
Objective To assess the effect of radical retropubic prostatectomy on erect
ile function, by evaluating objectively patients' erectile function before
and after surgery.
Patients and methods The study comprised 126 patients with clinically local
ized prostate cancer who were scheduled to undergo radical retropubic prost
atectomy. After giving informed consent for the study. 123 patients underwe
nt intracavernosal injection tests, colour Doppler ultrasonography and noct
urnal penile tumescence monitoring before and after surgery.
Results From the intracavernosal injection tests and nocturnal penile tumes
cence monitoring, 21 patients (17%) were evaluated as having normal erectil
e function before surgery. After radical retropubic prostatectomy, nine (43
%) of these 21 potent men had preserved erectile function. In eight patient
s Whose neurovascular bundles were preserved, five were potent after surger
y. The cause of erectile function after surgery was a neurogenic disorder i
n seven and it related vascular disorder in five.
Conclusion From objective tests of erectile function on patients scheduled
to undergo radical prostatectomy. 17% had normal erectile function. However
, even after nerve-sparing radical retropubic prostatectomy, the proportion
retaining potency was unsatisfactory. Although a neurological disorder wit
s the main cause of erectile dysfunction after surgery, vascular disorders
were also important.