Urology Service, Department Of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Cleveland Clinic Foundation Quantitative Health Sciences Division, Cleveland, OH, USA.
J Sex Med. 2019 Nov;16(11):1796-1802. doi: 10.1016/j.jsxm.2019.08.003. Epub 2019 Sep 11.
Given the number of confounders in predicting erectile function recovery after radical prostatectomy (RP), a nomogram predicting the chance to be functional after RP would be useful to patients' and clinicians' discussions.
To develop preoperative and postoperative nomograms to aid in the prediction of erectile function recovery after RP.
International Index of Erectile Function (IIEF) erectile function domain score-based erectile function.
A prospective quality-of-life database was used to develop a series of nomograms using multivariable ordinal logistic regression models. Standard preoperative and postoperative factors were included.
The nomograms predicted the probability of recovering functional erections (erectile function domain scores ≥24) and severe erectile dysfunction (≤10) 2 years after RP.
3 nomograms have been developed, including a preoperative, an early postoperative, and a 12-month postoperative version. The concordance indexes for all 3 exceeded 0.78, and the calibration was good.
These nomograms may aid clinicians in discussing erectile function recovery with patients undergoing RP.
STRENGTHS & LIMITATIONS: Strengths of this study included a large population, validated instrument, nerve-sparing grading, and nomograms that are well calibrated with excellent discrimination ability. Limitations include current absence of external validation and an overall low comorbidity index.
It is hoped that these nomograms will allow for a more accurate discussion between patients and clinicians regarding erectile function recovery after RP. Mulhall JP, Kattan MW, Bennett NE, et al. Development of Nomograms to Predict the Recovery of Erectile Function Following Radical Prostatectomy J Sex Med 2019;16:1796-1802.
鉴于预测根治性前列腺切除术（RP）后勃起功能恢复的混杂因素较多，因此预测 RP 后勃起功能恢复机会的列线图对患者和临床医生的讨论将非常有用。
建立术前和术后列线图，以辅助预测 RP 后勃起功能的恢复。
国际勃起功能指数(IIEF)勃起功能域评分的勃起功能。
使用多变量有序逻辑回归模型，利用前瞻性生活质量数据库建立了一系列列线图。纳入了标准的术前和术后因素。
列线图预测了 RP 后 2 年恢复功能性勃起（勃起功能域评分≥24）和严重勃起功能障碍（≤10）的概率。
建立了 3 个列线图，包括术前、早期术后和 12 个月术后版本。所有 3 个列线图的一致性指数均超过 0.78，且校准良好。
这些列线图可能有助于临床医生与接受 RP 的患者讨论勃起功能的恢复。
本研究的优势包括大样本量、验证工具、神经保留分级和列线图具有良好的校准和出色的区分能力。局限性包括目前缺乏外部验证和整体较低的合并症指数。
希望这些列线图能够使患者和临床医生在 RP 后勃起功能恢复方面进行更准确的讨论。Mulhall JP, Kattan MW, Bennett NE, et al. Development of Nomograms to Predict the Recovery of Erectile Function Following Radical Prostatectomy J Sex Med 2019;16:1796-1802.
