Transcutaneous electrical nerve stimulation (TENS) therapy in rehabilitating erectile dysfunction after bilateral nerve sparing robotic assisted radical prostatectomy.

Abstract

Aim: Erectile dysfunction (ED) represents one of the most clinically significant and detrimental quality-of-life complications in prostate cancer (PCa) patients following treatment. Different modalities are applied to improve and rehabilitate functional results, especially erectile function after radical prostatectomy (RP). We aimed to evaluate the effect of transcutaneous electrical nerve stimulation (TENS) on postoperative erectile function in patients who underwent bilateral nerve sparing robot-assisted radical prostatectomy (RARP).

Methods: The data of patients who underwent RARP for PCa were retrospectively examined. Patients were divided into two groups: those who underwent TENS to improve ED status after RARP (TENS(+)) and those who did not (TENS(-)). The patients' demographic data, surgical data, pre-op/post-op 3rd month International Prostate Symptom Score (IPSS), and pre-op/post-op 6th and 12th month International Index of Erectile Function (IIEF-5) data were evaluated.

Results: Of the 80 patients included in the study, 40 were allocated to the TENS(+) group and 40 to the TENS(-) group. The demographic and operative characteristics of the groups were similar. Preoperative and postoperative IPSS were statistically similar in both groups (p = 0.07 and p = 0.12, respectively). While, the mean preoperative IIEF-5 scores were similar for two groups, they were found to be statistically higher in the TENS(+) group in post-operative 6th months (p < 0.001). However, the improvement in IIEF score in the TENS(-) group was more pronounced during the second six months post-operatively, and no statistically significant difference was observed between the two groups at the 12th postoperative month (p = 0.12).

Conclusion: TENS therapy administered following RARP may be efficacious in penile rehabilitation 6 months post-surgery. TENS may be an alternative therapy for patients seeking early erectile recovery after RARP.