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Erectile Function after Non-Nerve-Sparing Radical Prostatectomy: Fact or Fiction?

Objective: To evaluate the potency in patients after radical perineal prostatectomy with wide excision of both neurovascular bundles. Material and Methods: In this prospective study, a quality-of-life questionnaire was completed by 128 patients at the preoperative stage, and 6 and 12 months postoperatively. Ten questions concerning the patient’s sexuality were included on the pre- and both postoperative questionnaires. In addition, 6 patients who recorded some erectile function were sent a separate questionnaire containing eight more detailed questions. Results: Preoperatively, 74/128 (57.8%) patients reported erections sufficient for sexual intercourse, and of these 74, 6 (8.1%) described having spontaneous erections 1 year postoperatively. These spontaneous erections occurred 1–5 times per week. The reply to the separate mailing made clear that the reported erections were insufficient for intercourse. Conclusions: Patients undergoing standardized radical prostatectomy with wide excision of the neurovascular bundle have a very small chance of spontaneous erections sufficient for intercourse postoperatively.