What does this research mean for the field?

Following radical prostatectomy, there is a significant discrepancy between patient-experienced erectile dysfunction and medical record documentation, with physicians failing to inquire about or document sexual health in nearly two-thirds of cases. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate how patients perceive erectile dysfunction compared to medical records after radical prostatectomy.

June 6, 2026

(535) Erectile Dysfunction After Radical Prostatectomy: Patient Perception Versus Medical Record Documentation

Puntos clave

To evaluate how patients perceive erectile dysfunction compared to medical records after radical prostatectomy.
Cohort study with 91 patients undergoing radical prostatectomy in São Paulo, Brazil
Postoperative assessment using the International Index of Erectile Function (IIEF-5) questionnaire
Comparison of patient-reported outcomes to medical record documentation.
48.4% of patients reported severe erectile dysfunction post-surgery
64.8% of patients indicated physicians did not inquire about erectile dysfunction in follow-up
Medical records documented 25.3% of patients with moderate to severe erectile dysfunction.

Resumen

Abstract Introduction Erectile dysfunction (ED) is a common complication after radical prostatectomy and can significantly affect patients’ quality of life. However, discrepancies may exist between patient-reported outcomes and medical record documentation. Objective To assess the patient’s perception of ED compared to what is recorded in medical charts following radical prostatectomy. Methods This cohort study included 91 patients who underwent radical prostatectomy for prostate cancer at a public hospital in the state of São Paulo, Brazil. The International Index of Erectile Function (IIEF-5) questionnaire was administered postoperatively, followed by interview and patient responses were compared to medical record entries. Results Mean age was 68,42 ± 6.7 years. ISUP 1 was observed in 2,20% ISUP 2 in 46,15%, ISUP 3 in 32,97%, ISUP 4 in 13,19% and ISUP 5 in 5,49% of the patients. Radical prostatectomy alone was performed in 64.84% of cases, 24.18% received radiotherapy with hormonal blockade, 5.49% had radiotherapy alone, and 5.49% received hormonal blockade only. IIEF-5 score among patients was distributed as follows: no ED in 5.5% of cases, mild ED in 6.6%, mild to moderate ED in 19.8%, moderate ED in 19.8%, and severe ED in 48.4%. A total of 64,8% of patients reported that physicians did not inquire about ED during postoperative follow-up. In the medical records, 64,8% of patients had no documentation regarding sexual activity, 1.1% had no ED and were not using phosphodiesterase type 5 inhibitors (PDE5i), 6.6% had preserved erections with PDE5i use, 2,2% use intracavernosal injection therapy and 25.3% had moderate to severe ED documented. Conclusions Most patients had moderate to severe ED, but sexual health was often overlooked in follow-up. Many were untreated, and documentation was frequently absent, highlighting the need for better assessment and management of sexual function post-treatment. Disclosure No

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