ABSTRACT
PURPOSE: Radical prostatectomy is the gold standard treatment for clinically localized prostate cancer, a disease whose incidence is increasing. Erectile dysfunction(ED) after radical prostatectomy influences a patient's quality of life significantly. So we evaluated the correlation of preoperative and postoperative factors with postoperative ED and its treatment. MATERIALS AND METHODS: Hospital records of 27 patients who underwent radical prostatectomy by one surgeon at our department were retrospectively reviewed. We performed univariate analyses to correlate preoperative prognostic factors with intaoperative factors and postoperative variables. RESULTS: Excluding 10 patients who had preoperative ED, erectile dysfunction developed in 10 of 17 patients, and the rate was higher in the older age group(p=0.02). Patients underwent non-nerve sparing radical prostatectomy maintained their potency in 0.0% (0/1) comparative with 44.4% (4/9) in unilateral nerve sparing and 42.9% (3/7) in bilateral nerve sparing surgery. Patients with preexisting comorbidity, such as cardiovascular disease(OR=2.38) and margin positivity(OR=4.67) had greater risk of postoperative ED. In 8 erectile dysfunction patients, 3 sildenafil-treated and 2 alprostadil-treated patients showed improvement one year after the operation. CONCLUSIONS: Older patients have greater risk of postoperative ED, and they have more preexisting risk factors including hypertension, cardiovascular disease, diabetes mellitus, and margin positivity.
Subject(s)
Humans , Male , Cardiovascular Diseases , Comorbidity , Diabetes Mellitus , Erectile Dysfunction , Hospital Records , Hypertension , Incidence , Prostatectomy , Prostatic Neoplasms , Quality of Life , Retrospective Studies , Risk Factors , Urinary IncontinenceABSTRACT
PURPOSE: Radical prostatectomy is the gold standard treatment for clinically localized prostate cancer, a disease whose incidence is increasing. Erectile dysfunction(ED) after radical prostatectomy influences a patient's quality of life significantly. So we evaluated the correlation of preoperative and postoperative factors with postoperative ED and its treatment. MATERIALS AND METHODS: Hospital records of 27 patients who underwent radical prostatectomy by one surgeon at our department were retrospectively reviewed. We performed univariate analyses to correlate preoperative prognostic factors with intaoperative factors and postoperative variables. RESULTS: Excluding 10 patients who had preoperative ED, erectile dysfunction developed in 10 of 17 patients, and the rate was higher in the older age group(p=0.02). Patients underwent non-nerve sparing radical prostatectomy maintained their potency in 0.0% (0/1) comparative with 44.4% (4/9) in unilateral nerve sparing and 42.9% (3/7) in bilateral nerve sparing surgery. Patients with preexisting comorbidity, such as cardiovascular disease(OR=2.38) and margin positivity(OR=4.67) had greater risk of postoperative ED. In 8 erectile dysfunction patients, 3 sildenafil-treated and 2 alprostadil-treated patients showed improvement one year after the operation. CONCLUSIONS: Older patients have greater risk of postoperative ED, and they have more preexisting risk factors including hypertension, cardiovascular disease, diabetes mellitus, and margin positivity.
Subject(s)
Humans , Male , Cardiovascular Diseases , Comorbidity , Diabetes Mellitus , Erectile Dysfunction , Hospital Records , Hypertension , Incidence , Prostatectomy , Prostatic Neoplasms , Quality of Life , Retrospective Studies , Risk Factors , Urinary IncontinenceABSTRACT
PURPOSE: We tried to determine how many patients comply with semen analysis recommendations after vasectomy and how often the operation is followed by surgical failure or recanalization. MATERIALS AND METHODS: We determined the percentage of patients who underwent vasectomy from 1995 to 2003 who had follow-up semen analysis. To determine the vasectomy failure or recanalization rate, we evaluated the rates of sperm appearance in patients who were preparing for vasovasostomy and those with chronic prostatitis who had undergone vasectomy in the past. RESULTS: Among the 130 vasectomized patients, 29(22.3%) had received semen analysis, and in 120 healthy vasectomized patients, only 19(9.9%) received semen analysis. Of the 8 semen samples examined before vasovasostomy, 2(25%) had sperm. In the 121 chronic prostatitis patients, 9(7.4%) had sperm in their semen despite earlier vasectomy. Overall, 11 of 129 vasectomized patients(8.5%) were potentially fertile. CONCLUSIONS: The vasectomy failure or recanalization rate is higher than we generally think. Vasectomy failure or recanalization is usually followed by unwanted pregnancy and abortion. Unfortunately, physicians as well as patients are indifferent to the need for post-vasectomy semen analysis, and we need to emphasize its importance.