Effect of radical retropubic prostatectomy on erectile function, evaluatedbefore and after surgery using colour Doppler ultrasonography and nocturnal penile tumescence monitoring

Objective To assess the effect of radical retropubic prostatectomy on erect ile function, by evaluating objectively patients' erectile function before and after surgery. Patients and methods The study comprised 126 patients with clinically local ized prostate cancer who were scheduled to undergo radical retropubic prost atectomy. After giving informed consent for the study. 123 patients underwe nt intracavernosal injection tests, colour Doppler ultrasonography and noct urnal penile tumescence monitoring before and after surgery. Results From the intracavernosal injection tests and nocturnal penile tumes cence monitoring, 21 patients (17%) were evaluated as having normal erectil e function before surgery. After radical retropubic prostatectomy, nine (43 %) of these 21 potent men had preserved erectile function. In eight patient s Whose neurovascular bundles were preserved, five were potent after surger y. The cause of erectile function after surgery was a neurogenic disorder i n seven and it related vascular disorder in five. Conclusion From objective tests of erectile function on patients scheduled to undergo radical prostatectomy. 17% had normal erectile function. However , even after nerve-sparing radical retropubic prostatectomy, the proportion retaining potency was unsatisfactory. Although a neurological disorder wit s the main cause of erectile dysfunction after surgery, vascular disorders were also important.