Erectile and Urinary Dysfunction After Radical Prostatectomy for Prostate Cancer in Quebec: a Population-based Study of 2415 Men

Objective: To assess and quantify urinary and sexual function outcomes from a large scale cohort of Canadian men treated for localized prostate cancer.

Methods: A self-administered survey focusing on erectile (ED) and urinary dysfunction (UD) was completed by 2415 of 4546 men (response rate 53.1%) treated with prostatectomy for prostate cancer in the Province of Quebec between 1988 and 1996. The time between treatment and survey completion ranged from 17 months to 8.5 years.

Results: After prostatectomy, of 2227 men without ED before surgery, erections of adequate firmness for intercourse were reported by 25%. ED rate increased with age and ranged from 55% in men aged <60 years to 85% in men 75 years or older. Of all, 19.1% reported ED treatment. ED rate was significantly related to UD severity. Severe UD, quantified as urinary leakage exceeding one tablespoon, was reported by 6.6%. Severe UD rate ranged from 4% in men aged <60 years to 10% in men 75 years or older. Strictures were reported by 16.3% and were associated with a two-fold increase in severe UD rate (p<0.001). Finally, age and socioeconomic status represented important predictor variables in univariate and multivariate regression models.

Conclusion: ED rate of 75% and severe UD rate of 6.6% could be anticipated after RP. These outcomes are similar to unselected large scale, patient reported outcomes from the United States.