Assessment of changes in penile sensation by electrophysiological study after radical prostatectomy: A pilot study

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Abstract

Background:

To evaluate the changes in penile sensation by electrophysiological tests in patients who underwent radical prostatectomy (RP) and to demonstrate the role of dorsal penile nerve injury in postoperative erectile dysfunction.

Materials and methods:

Twenty-six volunteer patients who were eligible for RP were included in the study. Preoperative penile sensory electromyography and the International Index of Erectile Function-5 (IIEF-5) questionnaire were done for each patient. Erectile function assessment and electrophysiological evaluation of penile sensation were repeated at postoperative 3rd and 6th months.

Results:

Postoperative IIEF-5 scores and electromyography values were significantly lower than preoperative findings ( p < 0.05). The IIEF-5 scores in the nerve sparing-RP (NS-RP) group were significantly higher than the non-nerve sparing-RP (NNS-RP) group in the postoperative period. Nerve conduction velocity values in the NS-RP group were also higher than the NNS-RP group at the postoperative 3rd and 6th months. However, these changes were not statistically significant ( p > 0.05).

Conclusions:

Patients who underwent RP have decreased penile sensation due to cavernous nerve damage and a possible dorsal penile nerve injury. The decrease of penile sensation may be associated with postoperative erectile dysfunction.

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Most cited references 31

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Cancer statistics, 2018

Kimberly D Miller, Rebecca Siegel, Ahmedin Jemal (2018)

Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths that will occur in the United States and compiles the most recent data on cancer incidence, mortality, and survival. Incidence data, available through 2014, were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data, available through 2015, were collected by the National Center for Health Statistics. In 2018, 1,735,350 new cancer cases and 609,640 cancer deaths are projected to occur in the United States. Over the past decade of data, the cancer incidence rate (2005-2014) was stable in women and declined by approximately 2% annually in men, while the cancer death rate (2006-2015) declined by about 1.5% annually in both men and women. The combined cancer death rate dropped continuously from 1991 to 2015 by a total of 26%, translating to approximately 2,378,600 fewer cancer deaths than would have been expected if death rates had remained at their peak. Of the 10 leading causes of death, only cancer declined from 2014 to 2015. In 2015, the cancer death rate was 14% higher in non-Hispanic blacks (NHBs) than non-Hispanic whites (NHWs) overall (death rate ratio [DRR], 1.14; 95% confidence interval [95% CI], 1.13-1.15), but the racial disparity was much larger for individuals aged <65 years (DRR, 1.31; 95% CI, 1.29-1.32) compared with those aged ≥65 years (DRR, 1.07; 95% CI, 1.06-1.09) and varied substantially by state. For example, the cancer death rate was lower in NHBs than NHWs in Massachusetts for all ages and in New York for individuals aged ≥65 years, whereas for those aged <65 years, it was 3 times higher in NHBs in the District of Columbia (DRR, 2.89; 95% CI, 2.16-3.91) and about 50% higher in Wisconsin (DRR, 1.78; 95% CI, 1.56-2.02), Kansas (DRR, 1.51; 95% CI, 1.25-1.81), Louisiana (DRR, 1.49; 95% CI, 1.38-1.60), Illinois (DRR, 1.48; 95% CI, 1.39-1.57), and California (DRR, 1.45; 95% CI, 1.38-1.54). Larger racial inequalities in young and middle-aged adults probably partly reflect less access to high-quality health care. CA Cancer J Clin 2018;68:7-30. © 2018 American Cancer Society.

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EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent.

Nicolas Mottet, Joaquim Bellmunt, MICHEL BOLLA … (2016)

To present a summary of the 2016 version of the European Association of Urology (EAU) - European Society for Radiotherapy & Oncology (ESTRO) - International Society of Geriatric Oncology (SIOG) Guidelines on screening, diagnosis, and local treatment with curative intent of clinically localised prostate cancer (PCa).

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Effect of nightly versus on-demand vardenafil on recovery of erectile function in men following bilateral nerve-sparing radical prostatectomy.

G B Brock, Liza Shapiro, Hendrik van den Bussche … (2008)

To date, no data have been available from large, well-designed trials comparing on demand and nightly dosing of phosphodiesterase type 5 (PDE5) inhibitors on recovery of erectile function in postprostatectomy patients with erectile dysfunction (ED). To investigate the effect of early postoperative dosing with vardenafil, administered either nightly or on demand, compared with placebo on recovery of erectile function in men with ED following bilateral nerve-sparing radical prostatectomy (NSRP) surgery. A randomised, double-blind, double-dummy, multicentre, parallel group study conducted at 87 centres across Europe, Canada, South Africa, and the United States. For inclusion, patients had to be scheduled to undergo bilateral NSRP within 1 mo of screening and have a normal International Index of Erectile Function erectile function domain (IIEF-EF) score of > or =26 at screening. A total of 628 men, aged 18-64 yr, were randomised to treatment. Study design consisted of a 9-mo double-blind treatment period, a 2-mo single-blind washout period, and an optional 2-mo open-label period. Patients received placebo, nightly vardenafil, or on demand vardenafil. Primary outcome measure was the percentage of subjects with an IIEF-EF score of > or =22 after the 2-mo washout period. Secondary variables included mean per-patient success rates for Sexual Encounter Profile (SEP) questions 2 and 3. No statistically significant differences were observed among treatment groups in the proportion of patients with an IIEF-EF score of > or =22 or in SEP3 success rates after the washout period. On-demand vardenafil treatment resulted in significantly greater IIEF-EF scores and better SEP3 response rates than placebo over the entire treatment period. In this study of men with ED following bilateral NSRP, vardenafil was efficacious when used on demand, supporting a paradigm shift towards on demand dosing with PDE5 inhibitors in this patient group. European clinical trials database (EudraCT; available at http://eudract.emea.europa.eu/). 11336.

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Author and article information

Journal

Journal ID (nlm-ta): Curr Urol

Journal ID (iso-abbrev): Curr Urol

Journal ID (publisher-id): CURR-UROL

Title: Current Urology

Publisher: Lippincott Williams & Wilkins (Hagerstown, MD )

ISSN (Print): 1661-7649

ISSN (Electronic): 1661-7657

Publication date (Print): June 2021

Publication date (Electronic): 04 May 2021

Volume: 15

Issue: 2

Pages: 111-114

Affiliations

[a ]Urology Department, Health of Science University Antalya, Training and Research Hospital, Antalya, Turkey

[b ]Physical Medicine and Rehabilitation Department, Health of Science University Antalya, Training and Research Hospital, Antalya, Turkey

Author notes

[∗ ]Corresponding Author: Ali Yildiz, Department of Urology, Antalya Training and Research Hospital, Antalya Eğitim Araştirma Hastanesi, Varlik Mh., 07050, Muratpaşa/Antalya, Turkey. E-mail address: ali.yildiz.88@ 123456gmail.com (A. Yildiz).

How to cite this article: Yildiz A, Islamoglu E, Yuksel M, Erol I, Karamik K, Cakir T, Ates M, Savas M. Assessment of changes in penile sensation by electrophysiological study after radical prostatectomy: A pilot study. Curr Urol. 2021;15(2):111–114. doi: 10.1097/CU9.0000000000000016.

Article

Publisher ID: CURR-UROL-21-0053 Accession ID: 00008

DOI: 10.1097/CU9.0000000000000016

PMC ID: 8221013

SO-VID: 72c751fb-04f6-476f-9d51-a03481259d18

License:

This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0

History

Date received : 18 November 2019

Date accepted : 10 January 2020

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Keywords: dorsal penile nerve,erectile dysfunction,penile sensation,prostate cancer,radical prostatectomy

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Keywords: dorsal penile nerve, erectile dysfunction, penile sensation, prostate cancer, radical prostatectomy

Assessment of changes in penile sensation by electrophysiological study after radical prostatectomy: A pilot study

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Most cited references 31

Cancer statistics, 2018

EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent.

Effect of nightly versus on-demand vardenafil on recovery of erectile function in men following bilateral nerve-sparing radical prostatectomy.

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