Comorbidities Associated with Erectile Dysfunction Following Radical Prostatectomy at a University Hospital

Enzo Faria Cunha, Fernando Nestor Facio Junior, Lilian Castiglioni, Ana Karoline Sepedro Lima, Mariana Carvalho Graziano
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Abstract

Prostate cancer is the second most common type of cancer among men. The main therapeutic approach is radical prostatectomy (RP), which exposes patients to erectile dysfunction (ED) as a postoperative risk. In the present retrospective study, records were analyzed of 431 patients submitted to RP. The prevalence of ED in the sample was 84.7%. Higher Gleason scores denote greater disease aggressivity and predispose patients to a greater use of tadalafil in the postoperative period. Older patients and those with high PSA levels used fewer medications for ED, possibly due to the lower response to the drugs. Moreover, ED following RP was correlated with anxiety and depression, predisposing patients to a greater use of medications for ED at the onset of treatment. Adjunct therapy to RP (hormone blocking and/or radiotherapy) was associated with a higher frequency of persistent ED. Thus, age, Gleason score, anxiety, depression, diabetes mellitus and adjunct therapy are variables that predispose patients to a higher incidence of erectile dysfunction following radical prostatectomy.
某大学医院根治性前列腺切除术后与勃起功能障碍相关的合并症
前列腺癌是男性中第二常见的癌症。主要的治疗方法是根治性前列腺切除术(RP),这暴露了患者勃起功能障碍(ED)作为术后风险。在本回顾性研究中,分析了431例接受RP的患者的记录。样本中ED的患病率为84.7%。Gleason评分越高,表明疾病侵袭性越强,术后患者更倾向于使用他达拉非。老年患者和PSA水平高的患者较少使用治疗ED的药物,可能是由于对药物的反应较低。此外,RP后的ED与焦虑和抑郁相关,使患者在治疗开始时更容易使用ED药物。RP的辅助治疗(激素阻断和/或放疗)与持续性ED的发生率较高相关。因此,年龄、Gleason评分、焦虑、抑郁、糖尿病和辅助治疗是根治性前列腺切除术后患者勃起功能障碍发生率较高的易感性变量。
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