Karaca Hakan, Sobay Resul, Mod Metin, Tahra Ahmet, Güngör Hasan Samet, İnkaya Abdurrahman, Küçük Eyüp Veli
Department of Urology, Ardahan State Hospital, 75000 Ardahan, Turkey.
Department of Urology, Health Science University Umraniye Training and Research Hospital, 34764 Istanbul, Turkey.
J Clin Med. 2025 Jul 10;14(14):4903. doi: 10.3390/jcm14144903.
Prostate cancer ranks as the second-most prevalent cancer globally, and is the fifth-ranking cause of cancer-related mortality. Radical prostatectomy presents a significant risk of postoperative sequelae, including erectile dysfunction. Postoperative erectile dysfunction adversely affects the patient's quality of life and can severely impact total treatment satisfaction. Nomograms have demonstrated efficacy in forecasting diverse outcomes in urology. We sought to create a nomogram to facilitate a more precise, evidence-based, and individualized prediction of erectile function outcomes following radical prostatectomy. Between January 2018 and January 2022, one hundred and eleven prostate cancer patients had robot-assisted radical prostatectomy, excluding those who had undergone prior transurethral prostatectomy, radiotherapy, or hormone therapy. Demographics, medical records, preoperative and postoperative erectile function statuses, and IIEF scores (≥17 indicating retained erections, <17 indicating full erectile dysfunction) were evaluated. : Patients' ages ranged from 45 to 76 years, with an average of 61.18 ± 6.72 years. Patients in the emergency department were considerably older ( = 0.004; < 0.01) and exhibited elevated Charlson Comorbidity Indices (3.63 ± 0.85; = 0.004; < 0.01). Preoperative IIEF scores in ED patients were lower (14.29 ± 5.34), although obturator internus thickness (20.61 ± 2.91) and intraprostatic urethra length (36.48 ± 9.3) were considerably elevated. Altered surgical techniques were linked to maintained erections ( = 0.002; < 0.01), but traditional approaches were connected with erectile dysfunction ( = 0.007; < 0.01). Bilateral nerve-sparing procedures were more prevalent among patients preserving erectile function ( = 0.003; < 0.01). : The nomogram, which includes age, Charlson Comorbidity Index, preoperative IIEF, obturator internus thickness, intraprostatic urethra length, surgical technique, and degree of nerve preservation, provides clinicians with a pragmatic instrument for forecasting postoperative erectile dysfunction in prostate cancer patients.
前列腺癌是全球第二大常见癌症，也是癌症相关死亡的第五大原因。根治性前列腺切除术存在术后后遗症的重大风险，包括勃起功能障碍。术后勃起功能障碍会对患者的生活质量产生不利影响，并可能严重影响总体治疗满意度。列线图已证明在预测泌尿外科的各种结果方面有效。我们试图创建一个列线图，以便更精确、基于证据且个性化地预测根治性前列腺切除术后的勃起功能结果。在2018年1月至2022年1月期间，111例前列腺癌患者接受了机器人辅助根治性前列腺切除术，排除那些先前接受过经尿道前列腺切除术、放疗或激素治疗的患者。评估了人口统计学、病历、术前和术后勃起功能状态以及国际勃起功能指数（IIEF）评分（≥17表示保留勃起功能，<17表示完全勃起功能障碍）。：患者年龄在45至76岁之间，平均年龄为61.18±6.72岁。急诊科的患者年龄明显更大（P = 0.004；<0.01），且查尔森合并症指数升高（3.63±0.85；P = 0.004；<0.01）。急诊科患者术前IIEF评分较低（14.29±5.34），尽管闭孔内肌厚度（20.61±2.91）和前列腺内尿道长度（36.48±9.3）明显升高。手术技术的改变与勃起功能的维持有关（P = 0.002；<0.01），但传统方法与勃起功能障碍有关（P = 0.007；<0.01）。保留勃起功能的患者中双侧神经保留手术更为普遍（P = 0.003；<0.01）。：该列线图包括年龄、查尔森合并症指数、术前IIEF、闭孔内肌厚度、前列腺内尿道长度、手术技术和神经保留程度，为临床医生提供了一种实用工具，用于预测前列腺癌患者术后的勃起功能障碍。
