Mp84-12 Outcomes and Factors Associated With Receipt of Open Vs Minimally Invasive Retroperitoneal Lymph Node Dissection (rplnd) for Testis Cancer: Analyzing the National Cancer Database (ncdb) From 2010-2014
Year: 2018
Type: article
Study design: Observational Study
Abstract: INTRODUCTION AND OBJECTIVES: The pathophysiology of erectile dysfunction (EF) after radical prostatectomy is believed to include neuropraxia, which leads to temporarily reduced oxygenation and subsequent structural changes in penile tissue.This results in veno-occlusive dysfunction, therefore, penile rehabilitation (PR) programmes focus on tissue oxygenation.Aim.Compare results of different types of PR such as vacuum erectile device (VED), PDE-5i pharmacotherapy (PDE-5i) and the combination therapy (CT).METHODS: We identified 83 sexually active patients who underwent nerve-sparing radical prostatectomy (NSRP).They were divided into 4 groups: the Ist without PR after NSRP (n¼24; 27.7%); the IInd taking PDE-5i after urinary catheter removal (n¼27; 32.5%); the IIIrd got VED therapy since the first month (n¼13; 22.8%) and the IVth got CT (n¼19; 18%).EF was examined by the International Index of Erectile Function (IIEF)-15 and by the Erection Hardness Score (EHS) questionnaires before and at 3, 6, and 12 months after surgery.Full recovery was defined as sexual intercourse with or without using PDE-5i; partial one as return spontaneous erections but insufficient for sexual intercourse; the development of ED as a complete lack of spontaneous erections in postoperative period.RESULTS: The IIEF score in the IIIrd group was 10.8 at 3 months and 19.4 at 12 months, compared with 7.5 and 13.8 at the same time points in the IInd group.Earlier recovery (on the 3rd month) of EF is noticed in patients got VED therapy (31%).Recovery rates of penile rigidity from baseline were 63% in the IIIrd group.CONCLUSIONS: Using VED therapy and PDE-5i after NSRP as single as in the combination leads to a significantly faster and great recovery of EF.Further studies are necessary for development of an algorithm of the choice of the PR option (VED, PDE-5i or CT) personalized for the patient after NSRP.
Source: The Journal of Urology
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2795399218