Purpose: This study considered the influence of the nerve-sparing procedure on early recovery of urinary continence after laparoscopic radical prostatectomy according to preoperative erectile function.
Patients and methods: There were 135 patients eligible for assessment of the status of urinary continence after surgery. The patients were divided into two groups according to the International Index of Erectile Function (IIEF)-5 score: Group 1, >or=14 (56 patients); group 2, <14 (79 patients). The correlation between urinary continence and patient age at surgery, body mass index, preoperative prostate-specific antigen level, preoperative IIEF-5 score, and an attempted nerve-sparing procedure was investigated.
Results: Overall continence rates were 13%, 41%, 63%, and 79% at 1, 3, 6, and 12 months, respectively. The rate in group 2 was significantly lower than that in group 1 6 months after surgery (P = 0.0286), and the rate in patients without attempted nerve sparing was significantly lower than that in those with an attempted nerve-sparing procedure at 3 months (P = 0.0084). The rate in group 2 of patients without attempted nerve sparing was significantly lower than that in those with an attempted nerve-sparing procedure at both 3 months (P = 0.0046) and 6 months postoperatively (P = 0.0356).
Conclusions: Preoperative erectile function and the nerve-sparing procedure were predictors of early recovery of urinary continence after laparoscopic radical prostatectomy. If each case fulfills the oncologic criteria for nerve sparing, we should attempt nerve sparing to facilitate the early recovery of urinary continence despite the degree of preoperative erectile function.