Recovery of sexual function after nerve-sparing radical prostatectomy or cystectomy

Background: The recovery of sexual function (erectile function and frequenc y of sexual intercourse) over time after nerve-sparing radical prostatectom y or cystoprostatectomy was evaluated. Methods: Forty-nine consecutive patients with clinically localized prostate cancer and muscle-invasive bladder cancer were treated with radical prosta tectomy and radical cystoprostatectomy with a nerve-sparing procedure. Erec tile function was evaluated by the circumferential change of the penis duri ng nocturnal penile tumescence (NPT value) with an erectometer before and a fter surgery. Erectile function and the frequency of sexual intercourse wer e also evaluated with a self-administered questionnaire before and after su rgery. Multivariate analysis by Cox's proportional hazards model was used t o evaluate the factor(s) that affected the recovery of erectile function an d sexual intercourse. Results: The recovery rates of erectile function were 49% at 3 years and 79 % at 5 years. For recovery of sexual intercourse the rates were 36% at 3 ye ars and 57% at 5 years. Multivariate analysis revealed that the preoperativ e NPT value was the only independent factor which significantly affected th e recovery of erectile function. The age at surgery was a significant facto r for recovery of sexual intercourse. Conclusion: Nerve-sparing operations can often, but not always, provide pre servation or recovery of erectile function for patients who receive radical prostatectomy or cystoprostatectomy. Recovery of erectile function depends upon the preoperative NPT value and recovery of sexual intercourse depends upon the age of the patient.