Restoration of erectile function in men after prostate surgery in the immediate postoperative period: the needs assessment for patients and their partners to maintain sexual relations

Abstract

Introduction. Despite the advances in the modern pharmacopoeia, a significant place is given to surgical methods of treating benign prostatic hyperplasia (BPH) and prostate cancer (PCa). In the postoperative period in men, sexual function usually deteriorates.Purpose of the study. To study the needs of men after prostate surgery and their sexual partners in restoring their previous sexual life.Materials and methods. The pilot open-label prospective randomized non-comparative study included 50 patients in the age range of 53 – 74 years (average 58.3 years). All patients were consistently admitted and operated on at the “Avicenna” Medical Centre, Ltd. (Novosibirsk) from January to December 2020. Upon admission, all patients completed the International Index of Erectile Function (ICEF) questionnaire; one month later, this questionnaire was re-completed, supplemented with five questions.Results. Twenty-one patients were admitted with a diagnosis of PCa T1c – T2N0M0, all of them underwent laparoscopic prostatectomy with lymphadenectomy. Twenty-nine patients were operated on for BPH. They underwent transurethral resection with a bipolar resectoscope. Only 6 patients (12%) had no comorbidities. Surgical intervention worsened sexual function in all patients, while in men aged 50 – 59 years, the IIEF score decreased by 61.0%, at the age of 60 – 69 years by 39.0%, in patients over 70 years old by 55.2%. Eighteen (36.0%) patients showed interest in restoring sexual function. Thirty-two (64%) patients were against the continuation of sexual activity with the following motivation: 19 (59.4%) – lack of desire for a sexual partner, 8 (25.0%) – lack of desire of the patient himself, 5 (15.6%) – unwillingness to re-operated. Nineteen women out of 36 stable couples (52.8%) objected to the restoration of the sexual function of their sexual partners.Conclusion. Prostate surgery affects male sexual function more severely in younger patients. Thirty-two patients after surgery refused to restore sexual activity, in more than half of cases (59.4%) due to the unwillingness of the sexual partner to resume sexual relations.