Nerve-sparing radical retropublic prostatectomy. Outcome analysis based onpatient questionnaires

Improved selection criteria have led to an increasing number of nerve-spari ng radical retropubic prostatectomies (RRP) in patients with clinically loc alized prostate cancer. The results based on patient questionnaires regardi ng postoperative erectile function are described. Between January 1992 and March 1999, 366 patients (mean age: 62.5 years) un derwent uni- or bilateral nerve-sparing RRP at our institution. For evaluat ion of postoperative patient-reported rates of sexual and erectile function , a questionnaire was used after a follow-up of at least 12 months. Data of five operation periods were analyzed. The results of the unilateral procedure for the five operation periods reve aled consistent rates of 13-29% for erections sufficient for intercourse. B ilateral nerve-sparing procedures were almost exclusively performed in peri ods 3 to 5; only four patients from period 2 underwent the bilateral proced ure. The rates of intercourse-sufficient erections were 25% (period 2),61% (period 3),50% (period 4), and 52% (period 5), respectively. The results of the unilateral procedure were disappointing. However, the bi lateral nerve-sparing method achieved much better results inasmuch as about 50% of the patients reported recovery of erections sufficient for sexual i ntercourse.