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A comparative study of erectile function and use of erectile aids in high-risk prostate cancer patients after robot-assisted laparoscopic prostatectomy

Abstract Objective. Erectile function with and without use of erectile aids was compared in high-, intermediate- and low-risk prostate cancer patients at a mean of 3 years after robot-assisted laparoscopic prostatectomy (RALP). Materials and methods. A sample of 982 men who underwent RALP at Oslo University Hospital, Radiumhospitalet, between 2005 and 2010 was invited to complete a mailed questionnaire in 2011. The response rate was 79%, but only 609 patients did not have adjuvant treatment and reported on erection. The sample consisted of 29% high-risk, 40% intermediate-risk and 25% low-risk patients according to the preoperative D’Amico classification. Based on questionnaire data, two primary outcomes were defined: ability to have intercourse (sufficient erection), and use and effect of erectile aids. Results. Sufficient erection with or without erectile aids was reported by 19% of the high-, 30% of the intermediate- and 19% of the low-risk group (not significant). Erectile aids were used by 48% of the sample, of whom 18% of the high-, 21% of the intermediate- and 14% of the low-risk group reported sufficient erection (not significant). Papaverine injections were used by 21% and phosphodiesterase-5 inhibitors by 28% of the sample. Limitations were the lack of data on erection baseline and on penile rehabilitation. Conclusions. Nearly half of the sample used erectile aids, which significantly increased the proportion with sufficient erection in all risk groups after RALP. With and without the use of erectile aids, the proportions of patients with sufficient erection were 30% or less, with non-significant differences between groups.