Pd32-01 Probability of Drug-Unassisted Erectile Function Recovery After Robot-Assisted Radical Prostatectomy in a Contemporary Series

You have accessJournal of UrologySexual Function/Dysfunction: Evaluation II (PD32)1 May 2024PD32-01 PROBABILITY OF DRUG-UNASSISTED ERECTILE FUNCTION RECOVERY AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY IN A CONTEMPORARY SERIES Paolo Capogrosso, Mattia Longoni, Alessandro Bertini, Giorgio Gandaglia, Federico Dehò, D.'Ambrosio Lucia, Nadia Finocchio, Alberto Briganti, Andrea Salonia, and Francesco Montorsi Paolo CapogrossoPaolo Capogrosso , Mattia LongoniMattia Longoni , Alessandro BertiniAlessandro Bertini , Giorgio GandagliaGiorgio Gandaglia , Federico DehòFederico Dehò , D.'Ambrosio LuciaD.'Ambrosio Lucia , Nadia FinocchioNadia Finocchio , Alberto BrigantiAlberto Briganti , Andrea SaloniaAndrea Salonia , and Francesco MontorsiFrancesco Montorsi View All Author Informationhttps://doi.org/10.1097/01.JU.0001009364.27111.54.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The primary objective of penile rehabilitation following robot-assisted radical prostatectomy (RARP) is the recovery of spontaneous, unassisted erectile function (EF). However, the rate of unassisted postoperative EF recovery has been scantly reported. We investigated the rate of unassisted EF in a contemporary series of patients treated with RARP. METHODS: Data from 209 patients treated with RARP for localized PCa by a single experienced surgeon between 2017 and 2023 have been analysed. Patients who had received neoadjuvant, adjuvant or salvage treatments were excluded. All patients were prescribed daily tadalafil after surgery, with or without intracavernous injections of vasoactive agents (trimix) 3 times a week for at least 12 months. Patients were allowed to continue these medications if needed. Patients were followed-up at 3, 6 and 12 months and then annually. EF was evaluated with the IIEF-EF and EF recovery was defined as an IIEF-EF >21. Kaplan Meier analysis estimated the rate of post-RARP assisted and unassisted EF recovery. Predictors or unassisted EF recovery were assessed with Cox regression and descriptive statistics. RESULTS: Complete data were available for 163 patients. Median (IQR) baseline IIEF-EF was 27 (19 - 29) suggesting good preoperative EF. Overall, 131 (78%) patients underwent a bilateral nerve-sparing RARP. At last follow-up, 98 (60.3%) patients were still using ED medications, while 65 (39.7%) had either discontinued or even never initiated the prescribed drug. At Kaplan-Meier, the estimated rate of assisted EF recovery at 24 months post-RARP was 67% (95%CI: 52,81) compared to a rate of unassisted EF recovery of 13% (95%CI:7,25) (p<0.0001) (Fig). Patients recovering unassisted EF appeared younger (60.6 vs. 66.1 years; p=0.02) and with higher baseline IIEF-EF (29 vs. 24; p=0.02). Age resulted as the only predictor of unassisted EF recovery at Cox-regression (HR: 0.89; 0.81-0.97, p=0.01). CONCLUSIONS: Findings from a contemporary series of PCa patients treated with RARP suggest that despite the advancements in surgical technique and postoperative care, the rate of unassisted EF recovery remains low. Patients should be properly counselled regarding the high likelihood of requiring postoperative ED medications, especially at older ages. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e703 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Paolo Capogrosso More articles by this author Mattia Longoni More articles by this author Alessandro Bertini More articles by this author Giorgio Gandaglia More articles by this author Federico Dehò More articles by this author D.'Ambrosio Lucia More articles by this author Nadia Finocchio More articles by this author Alberto Briganti More articles by this author Andrea Salonia More articles by this author Francesco Montorsi More articles by this author Expand All Advertisement PDF downloadLoading ...