Clinical and Surgical Predictors of Erectile Dysfunction after Bilateral Nerve-Sparing Laparoscopic Radical Prostatectomy.

IF 0.9 4区医学 Q4 UROLOGY & NEPHROLOGY

Archivos Espanoles De Urologia Pub Date : 2025-07-01 DOI:10.56434/j.arch.esp.urol.20257806.90

Hakan Tekinaslan, Osman Köse, Serkan Özcan, Sacit Nuri Görgel, Yiğit Akın

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引用次数: 0

Abstract

Objective: To investigate the predictors of postoperative erectile dysfunction (ED) in patients who underwent bilateral nerve-sparing laparoscopic radical prostatectomy (BNLRP).

Materials and methods: Patients with preoperative ED were excluded. Postoperative erectile function was assessed using the International Index of Erectile Function-5 (IIEF-5) at 6 months postoperatively, with a cutoff score of ≤12 to define ED. The diagnostic value of associated factors was assessed using odds ratios (ORs) with 95% confidence intervals (CIs) based on univariate and multivariate logistic regression analyses. Only variables with p < 0.05 in univariate analysis were included in the multivariate model to avoid multicollinearity and overfitting.

Results: A retrospective review was conducted on 79 patients who underwent BNLRP for localised prostate cancer between April 2020 and March 2023. Postoperative ED was observed in 37 (46.8%) patients. Univariate analysis revealed significant associations between ED and age (p < 0.001), diabetes mellitus (p < 0.001), coronary artery disease (p < 0.001), hypertension (p < 0.001), Gleason score (p < 0.001), operative time (p < 0.001) and intraoperative blood loss (p < 0.001). Multivariate logistic regression identified age (OR: 1.136, p = 0.046), diabetes mellitus (OR: 32.706, p = 0.003), Gleason score (OR: 4.749, p = 0.015), operative time (OR: 1.200, p = 0.001) and blood loss (OR: 1.010, p = 0.039) as independent predictors.

Conclusions: ED after BNLRP is associated with patient-related and surgical factors. Identifying these predictors may improve preoperative counselling and support early postoperative rehabilitation strategies. Prospective multicentre studies are necessary to externally validate these findings.

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保留双侧神经的腹腔镜根治性前列腺切除术后勃起功能障碍的临床和手术预测因素。

目的：探讨双侧保神经腹腔镜根治性前列腺切除术（BNLRP）患者术后勃起功能障碍（ED）的预测因素。材料与方法：排除术前ED患者。术后6个月使用国际勃起功能指数-5 （IIEF-5）评估术后勃起功能，临界值≤12定义ED。基于单因素和多因素logistic回归分析，使用比值比（ORs）和95%置信区间（CIs）评估相关因素的诊断价值。为了避免多重共线性和过拟合，我们只将单因素分析中p < 0.05的变量纳入多元模型。结果：对2020年4月至2023年3月期间接受局限性前列腺癌BNLRP治疗的79例患者进行了回顾性研究。术后出现ED 37例（46.8%）。单因素分析显示，ED与年龄（p < 0.001）、糖尿病（p < 0.001）、冠状动脉疾病（p < 0.001）、高血压（p < 0.001）、Gleason评分（p < 0.001）、手术时间（p < 0.001）和术中出血量（p < 0.001）有显著相关性。多因素logistic回归确定年龄（OR: 1.136, p = 0.046）、糖尿病（OR: 32.706, p = 0.003）、Gleason评分（OR: 4.749, p = 0.015）、手术时间（OR: 1.200, p = 0.001）和出血量（OR: 1.010, p = 0.039）为独立预测因素。结论：BNLRP术后ED与患者相关因素和手术因素有关。确定这些预测因素可以改善术前咨询和支持早期术后康复策略。有必要进行前瞻性多中心研究以从外部验证这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archivos Espanoles De Urologia UROLOGY & NEPHROLOGY-

CiteScore

0.90

自引率

0.00%

发文量

111

期刊介绍： Archivos Españoles de Urología published since 1944, is an international peer review, susbscription Journal on Urology with original and review articles on different subjets in Urology: oncology, endourology, laparoscopic, andrology, lithiasis, pediatrics , urodynamics,... Case Report are also admitted.