Department of Surgery, Royal Perth Hospital, Perth, Australia.
BJU Int. 2013 Apr;111(4):653-7. doi: 10.1111/j.1464-410X.2012.11321.x. Epub 2012 Jul 3.
WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Erectile function recovery after radical prostatectomy is affected by surgical technique and patient factors. Age and preoperative erectile function are the 2 patient factors that have been consistently shown to impact postoperative erectile function. The presence of vascular risk factors preoperatively seems to negatively impact erectile function recovery after radical prostatectomy independently from age, preoperative erectile function and surgical technique.
To examine whether vascular risk factors (VRFs) affect erectile function (EF) recovery after radical prostatectomy (RP).
From our prospective database we identified patients with clinically localised prostate cancer who had undergone RP and had preoperative information on EF and VRFs (hypertension, hypercholesterolaemia, diabetes mellitus, coronary artery disease [CAD], and cigarette smoking), surgeon-graded nerve-sparing status, and EF data collected between 24 and 30 months after RP.
In all, 984 patients were included in the analyses. The frequency of the VRFs was as follows: hypertension (38%), hypercholesterolaemia (36%), diabetes mellitus (7%), CAD (5%), and cigarette smoking (37%). On univariate analysis, EF between 24 and 30 months was associated with age (r = 0.37, P < 0.001), EF before RP (r = 0.41, P < 0.001), NSS (r = 0.35, P < 0.001), and VRFs (0-2 vs >3 VRFs; r = 0.15, P = 0.003). On multivariable analysis all variables remained statistically significant, and accounted for 28% of the total variance in EF between 24 and 30 months after RP.
The presence of VRFs seems to adversely affect EF recovery after RP independently of other factors. This observation might be useful for improving patient counselling before treatment and to support the development of new treatment strategies for erectile dysfunction after RP.
检查血管危险因素（VRF）是否会影响根治性前列腺切除术（RP）后的勃起功能（EF）恢复。
我们从我们的前瞻性数据库中确定了患有临床局限性前列腺癌的患者，这些患者接受了 RP 手术，并在术前有 EF 和 VRF 信息（高血压、高胆固醇血症、糖尿病、冠心病 [CAD] 和吸烟）、外科医生分级的神经保留状况，以及 RP 后 24 至 30 个月收集的 EF 数据。
共有 984 名患者纳入分析。VRF 的频率如下：高血压（38%）、高胆固醇血症（36%）、糖尿病（7%）、CAD（5%）和吸烟（37%）。在单变量分析中，EF 在 24 至 30 个月之间与年龄（r = 0.37，P < 0.001）、RP 前的 EF（r = 0.41，P < 0.001）、NSS（r = 0.35，P < 0.001）和 VRFs（0-2 个与 >3 个 VRFs；r = 0.15，P = 0.003）相关。多变量分析中所有变量均具有统计学意义，占 RP 后 24 至 30 个月 EF 总方差的 28%。
VRF 的存在似乎独立于其他因素对 RP 后的 EF 恢复产生不利影响。这一观察结果可能有助于改善治疗前的患者咨询，并为 RP 后勃起功能障碍的新治疗策略的发展提供支持。
