Sexual dysfunction after radical prostatectomy: Treatment failure or treatment delay?

Gila Bronner*, Shai Shefi, Gil Raviv

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

This study defines characteristics of delayed help-seeking in men who fail phosphodiesterase-5 inhibitors (PDE5I) treatment for their post radical retropubic prostatectomy (RRP) erectile dysfunction (ED). Medical charts were reviewed retrospectively. All men were offered second line treatment with vacuum devices or intracavernous injection (ICI) and sex therapy. This study included thirty one patients. Average age at surgery was 60 years (SD = 5.3, range 46-70). Average period for second line help-seeking was 25.9 months (SD = 12.9, range 3-111). All subjects believed that surgery would not affect their sexual function. Twenty men (65%) used ICI as a second line treatment. Eleven men (35%) declined treatment, waiting for spontaneous recovery. In ICI sub-group, 5 men (25%) regained spontaneous erection within 7-10 months after initial treatment (16-19 months post-surgery). Seven men (35%) responded positively to PDE5I 3-5 months after starting ICI. Three men (15%) used vacuum device. None regained spontaneous erection. All 7 men (23%) who met sex therapist with their partner reported improved sexual life, even if ED wasn't resolved. Patients should receive comprehensive information about sexual recovery, to encourage early ED treatment after RRP and to overcome unwanted misconceptions regarding spontaneous recovery.

Original languageEnglish
Pages (from-to)421-429
Number of pages9
JournalJournal of Sex and Marital Therapy
Volume36
Issue number5
DOIs
StatePublished - Oct 2010
Externally publishedYes

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