Continence and erectile function between 2 and 4 years post-surgery


There are few published reports on changes in continence and erectile function beyond 2 years after radical prostatectomy. A newly published, prospective study has reported on continence and erectile function between 2 and 4 years after radical prostatectomy.

Glickman et al. have reported data on 731 consecutive men who underwent open radical retropubic prostatectomy for clinically localized prostate cancer between October 2000 and August 2003. Preoperative and postoperative continence, and erectile function, were ascertained using the UCLA Prostate Cancer Index. In addition, a 48-month prospective self-assessment follow-up questionnaire captured changes in urinary control and erectile function between 24 and 48 months after treatment, including marked improvement, moderate improvement, slight improvement, no change, or worsening.

The authors report the results of this study as follows:

  • Between 24 and 48 months after radical prostatectomy 23.4 and 42.3 percent of men, overall, showed any degree of improvement in continence and erectile function, respectively.
  • During the same time period, 12.2 and 19.8 percent of the patients showed marked and moderate improvement in continence and erectile function, respectively.
  • The probability of experiencing any qualitative improvement in urinary continence was not significantly different in men who were continent or incontinent at 24 months.
  • The likelihood of experiencing any qualitative improvement in erectile function was significantly greater in men who were potent at 24 months compared to those who were impotent at that time.

The authors write that their data provide “compelling evidence that clinically significant improvements in urinary control and erectile function occur beyond 2 years after radical prostatectomy” and that  “These qualitative improvements are greatest for erectile function in men who were potent at 2 years.”

From a practical point of view, they further state that, “men should not be counseled that maximal urinary continence or erectile function are achieved by 24 months after radical prostatectomy.”

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