To investigate the predictors of postoperative erectile dysfunction (ED) in patients who underwent bilateral nerve-sparing laparoscopic radical prostatectomy (BNLRP). Patients with preoperative ED were excluded. Postoperative erectile function was assessed using the International Index of Erectile Function-5 (IIEF-5) at 6 months postoperatively, with a cutoff score of ≤12 to define ED. The diagnostic value of associated factors was assessed using odds ratios (ORs) with 95% confidence intervals (CIs) based on univariate and multivariate logistic regression analyses. Only variables with p < 0.05 in univariate analysis were included in the multivariate model to avoid multicollinearity and overfitting. A retrospective review was conducted on 79 patients who underwent BNLRP for localised prostate cancer between April 2020 and March 2023. Postoperative ED was observed in 37 (46.8%) patients. Univariate analysis revealed significant associations between ED and age (p < 0.001), diabetes mellitus (p < 0.001), coronary artery disease (p < 0.001), hypertension (p < 0.001), Gleason score (p < 0.001), operative time (p < 0.001) and intraoperative blood loss (p < 0.001). Multivariate logistic regression identified age (OR: 1.136, p = 0.046), diabetes mellitus (OR: 32.706, p = 0.003), Gleason score (OR: 4.749, p = 0.015), operative time (OR: 1.200, p = 0.001) and blood loss (OR: 1.010, p = 0.039) as independent predictors. ED after BNLRP is associated with patient-related and surgical factors. Identifying these predictors may improve preoperative counselling and support early postoperative rehabilitation strategies. Prospective multicentre studies are necessary to externally validate these findings.
Tekinaslan et al. (Wed,) studied this question.