Prostate Cancer Patients Keep Sexual Function

Nerve sparing radical prostatectomy promotes better sexual and urinary functioning than non nerve sparing

(RxWiki News) Prostate cancer patients have different treatment options nowadays. Most men probably want treatments that won't harm their overall health or sex life.

Radical prostatectomy is used to treat early prostate cancer that hasn't spread. This type of operation removes all of the prostate gland.

It may also cause problems with sex and urination, making some patients reluctant to have this procedure.

But, according to new research, nerve-sparing radical prostatectomy doesn't damage the nerves that aid in erections. By sparing these nerves, the patient has a better chance of having a good sex life.

"Ask about new prostate treatments."

Catherine Harris, MD, of Department of Urology, University of California San Francisco, and colleagues set out to measure the effect of nerve sparing and non-sparing radical prostatectomies on sexual and urinary functioning in men. 

Researchers were also interested in how patients fared after surgery if they previously had sex problems.

The study included 1,322 patients who had a radical prostatectomy and were followed for two years. The average age was 61. The degrees of nerve sparing prostatectomy procedures were complete bilateral (complete nerve sparing), unilateral/partial (not complete nerve sparing) and no nerve sparing.

A questionnaire that was designed for prostate cancer patients measured sexual function, sexual bother, urinary function and urinary bother. Patients that had sexual issues prior to the prostate surgery were divided into groups based on the severity of their problems.

Results showed that patients who had nerve sparing radical prostatectomies had better sexual outcomes compared to those with no nerves spared during surgery. However, nerve sparing patients that had severe sexual dysfunction prior to surgery did not see improvement in sexual functioning.

All patients with nerve sparing procedures reported positive urinary outcomes.

Patients who underwent bilateral nerve sparing had better sexual outcomes compared to those who underwent unilateral nerve sparing, but only for those men who reported the fewest sexual functioning issues prior to surgery.

There was not a significant difference between unilateral nerve sparing and no nerve sparing on sexual functioning.

Researchers suggested that men who are good candidates for nerve-sparing surgery should consider the option, even men with severe sexual problems, as the surgery can help with urinary functioning.

There were some limitations to this research. The study only included men who had completed questionnaires at the start of the study and at two years. The data did not show an overall significant interaction between nerve sparing and urinary functioning. 

But the data did show an effect when it was analyzed based on pre-surgery sexual functioning. The researchers said it should be interpreted with caution. Information about whether the patients used sexual aids (including medication) was not collected and could have affected outcomes.

This study, titled "Men with Low Preoperative Sexual Function May Benefit From Nerve-sparing Radical Prostatectomy," was published in The Journal of Urology. It was supported by The Cancer of the Prostate Strategic Urologic Research Endeavor and University of California at San Francisco. Dr. Harris and colleagues disclosed no conflict of interest.

Review Date: 
February 20, 2013