The Assessment of Erectile Dysfunction After Radical Prostatectomy Using Pudendal Somatosensory Evoked Potential

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2023 Nov 29

PMID 38019800

Authors

Se Yun Kwon

Jin-Mo Park

Affiliations

Soon will be listed here.

Abstract

Erectile dysfunction in patients who underwent radical prostatectomy was evaluated with pudendal somatosensory evoked potentials (PSEP) to measure and predict erectile dysfunction objectively. Fifty-seven patients who completed requirements were included in the study. Patients were divided into 2 groups (potency/non-potency). Erectile function recovery was defined as question 2 and 3 on the IIEF-5 questionnaire at 12 months after surgery. The two-channel PSEP test was performed at the day before RP and 3-6 months after RP. Twenty patients were assigned to the potency group and 37 to the non-potency group. Mean age was less in the potency group. Other clinical variables were similar in two groups. The non-potency group had prolonged lumbar and cortical latencies in postoperative PSEP, and the mean differences of latencies between pre- and postoperative PSEP in lumbar and cortical regions were also greater in the non-potency group. Logistic regression analysis showed that age, lumbar post-operative latency, cortical post-operative latency, and difference of latency in lumbar region were associated with non-potency; odds ratios were 1.292 (p = 0.018), 0.425 (p = 0.047), 1.637 (p < 0.001), and 3.272 (p = 0.010), respectively. This study suggests that PSEP is an effective means of evaluating erectile dysfunction in prostate cancer patients after surgery.

References

Kwon S, Lee J, Ha Y, Choi S, Kim T, Kwon T . Open radical prostatectomy reproducing robot-assisted radical prostatectomy: Involving antegrade nerve sparing and continuous anastomosis. Int Braz J Urol. 2017; 43(6):1043-1051. PMC: 5734066. DOI: 10.1590/S1677-5538.IBJU.2016.0627. View

Arroyo C, Martini A, Wang J, Tewari A . Anatomical, surgical and technical factors influencing continence after radical prostatectomy. Ther Adv Urol. 2019; 11:1756287218813787. PMC: 6329031. DOI: 10.1177/1756287218813787. View

Park Y, Kwon O, Hong S, Kim S, Hwang T, Lee J . Effect of Nerve-Sparing Radical Prostatectomy on Urinary Continence in Patients With Preoperative Erectile Dysfunction. Int Neurourol J. 2016; 20(1):69-74. PMC: 4819157. DOI: 10.5213/inj.1630428.214. View

Koo K, Jung D, Lee S, Choi Y, Chung B, Hong S . Feasibility of robot-assisted radical prostatectomy for very-high risk prostate cancer: surgical and oncological outcomes in men aged ≥70 years. Prostate Int. 2014; 2(3):127-32. PMC: 4186956. DOI: 10.12954/PI.14050. View

Capogrosso P, Vertosick E, Benfante N, Eastham J, Scardino P, Vickers A . Are We Improving Erectile Function Recovery After Radical Prostatectomy? Analysis of Patients Treated over the Last Decade. Eur Urol. 2018; 75(2):221-228. PMC: 6339580. DOI: 10.1016/j.eururo.2018.08.039. View

Frota R, Turna B, Barros R, Gill I . Comparison of radical prostatectomy techniques: open, laparoscopic and robotic assisted. Int Braz J Urol. 2008; 34(3):259-68. DOI: 10.1590/s1677-55382008000300002. View

Lee J, Sjoberg D, Miller M, Vickers A, Mulhall J, Ehdaie B . Improved Recovery of Erectile Function in Younger Men after Radical Prostatectomy: Does it Justify Immediate Surgery in Low-risk Patients?. Eur Urol. 2017; 73(1):33-37. PMC: 5732855. DOI: 10.1016/j.eururo.2017.08.007. View

Leow J, Chang S, Meyer C, Wang Y, Hanske J, Sammon J . Robot-assisted Versus Open Radical Prostatectomy: A Contemporary Analysis of an All-payer Discharge Database. Eur Urol. 2016; 70(5):837-845. DOI: 10.1016/j.eururo.2016.01.044. View

Tholomier C, Couture F, Ajib K, Preisser F, Bondarenko H, Negrean C . Oncological and functional outcomes of a large Canadian robotic-assisted radical prostatectomy database with 10 years of surgical experience. Can J Urol. 2019; 26(4):9843-9851. View

10.

Podnar S . Neurophysiology of the neurogenic lower urinary tract disorders. Clin Neurophysiol. 2007; 118(7):1423-37. DOI: 10.1016/j.clinph.2007.01.022. View

11.

Muzyka I, Estephan B . Somatosensory evoked potentials. Handb Clin Neurol. 2019; 160:523-540. DOI: 10.1016/B978-0-444-64032-1.00035-7. View

12.

Ku J, Lee C, Lee J, Ha H . Comparison of functional outcomes between laparoscopic radical prostatectomy and robot-assisted laparoscopic radical prostatectomy: a propensity score-matched comparison study. Asia Pac J Clin Oncol. 2016; 13(3):212-218. DOI: 10.1111/ajco.12595. View

13.

Montorsi F, Briganti A, Salonia A, Rigatti P, Burnett A . Current and future strategies for preventing and managing erectile dysfunction following radical prostatectomy. Eur Urol. 2004; 45(2):123-33. DOI: 10.1016/j.eururo.2003.08.016. View

14.

Walsh P . Anatomic radical prostatectomy: evolution of the surgical technique. J Urol. 1998; 160(6 Pt 2):2418-24. DOI: 10.1097/00005392-199812020-00010. View

15.

Bianchi F, Squintani G, Osio M, Morini A, Bana C, Ardolino G . Neurophysiology of the pelvic floor in clinical practice: a systematic literature review. Funct Neurol. 2018; 22(4):173-193. PMC: 5762103. DOI: 10.11138/fneur/2017.32.4.173. View

16.

Walz J, Epstein J, Ganzer R, Graefen M, Guazzoni G, Kaouk J . A Critical Analysis of the Current Knowledge of Surgical Anatomy of the Prostate Related to Optimisation of Cancer Control and Preservation of Continence and Erection in Candidates for Radical Prostatectomy: An Update. Eur Urol. 2016; 70(2):301-11. DOI: 10.1016/j.eururo.2016.01.026. View

17.

Salonia A, Castagna G, Capogrosso P, Castiglione F, Briganti A, Montorsi F . Prevention and management of post prostatectomy erectile dysfunction. Transl Androl Urol. 2016; 4(4):421-37. PMC: 4708594. DOI: 10.3978/j.issn.2223-4683.2013.09.10. View

18.

Klausner A, Batra A . Pudendal nerve somatosensory evoked potentials in patients with voiding and/or erectile dysfunction: correlating test results with clinical findings. J Urol. 1996; 156(4):1425-7. View

19.

Giuliano F, Rowland D . Standard operating procedures for neurophysiologic assessment of male sexual dysfunction. J Sex Med. 2013; 10(5):1205-11. DOI: 10.1111/jsm.12164. View

20.

Ko Y . Functional recovery after radical prostatectomy for prostate cancer. Yeungnam Univ J Med. 2019; 35(2):141-149. PMC: 6784702. DOI: 10.12701/yujm.2018.35.2.141. View