DOI: 10.25881/BPNMSC.2019.86.92.013

Authors

Magomedov Sh.S., Nesterov S.N., Hanaliev B.V., Kosarev E.I., Barsegyan A.G., Volodichev V.V.

Federal State Public Institution «National Medical and Surgical Center named after N.I. Pirogov» of the Ministry of Healthcare of the Russian Federation

Abstract

Purpose of research. To study the risk factors associated with the development of erectile dysfunction and urinary incontinence in patients undergoing robot-assisted prostatectomy (RARP).

Materials and methods. The study involved 570 patients who underwent RARP in connection with diagnosed prostate cancer (PC). In the future, a comparative analysis of clinical characteristics of patients with urinary incontinence, erectile dysfunction and other patients was carried out. In particular, a multiparameter regression analysis was conducted to identify risk factors associated with urinary incontinence and erectile dysfunction.

Results. Most patients after RARP were with moderate or severe ED (519 patients, or 91.1%). The average value of IIEF-5 score was 11.5 ± 3.4 after RARP after 12 months of observation and treatment, which significantly differs from the value of IIEF-5 score before surgery - 20.0 ± 3.4 (p <0.05). Severe ED is associated with overweight (OR = 3.45; CI 2.23 – 4.55, p<0.05); prostate volume (OR = 1.12; CI 1.10 – 1.45, p<0.05); Smoking (OR = 3.44 CI 2.45 – 5.89, p < 0.05). The lack of nerve-saving technique was also associated with the development of severe ED (OR = 1.76; CI 1.45 – 2.23, p<0.05) in contrast to the mild and moderate severity of ED, where there were no such associations. Urinary incontinence is associated with a large prostate volume (OR = 3.18; CI 2.32 – 12.7, p=0.001), with age over 65 years (OR = 2.31; CI 1.62 – 5.56, p = 0.005), overweight (OR = 3.54; CI 1.56 – 8.32, p = 0.001), and smoking (OR = 1.35; CI 1.23 – 3.77, p = 0.001).

Discussion. All patients after prostatectomy develop ED, but the presence of risk factors (Smoking, obesity, large prostate) affects the degree of severity of ED (moderate and severe). The probability of developing urinary incontinence is about 18% according to different data. This frequency can be reduced by correcting risk factors such as obesity, prostate volume, the number of cigarettes smoked per day.

Summary. The probability of developing ED moderate and severe can be reduced by reducing body weight, reducing the number of cigarettes smoked per day, performing nerve-saving techniques.

Keywords: radical prostatectomy, urinary incontinence, prostate cancer, urinary incontinence, erectile dysfunction.

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For citation

Magomedov Sh.S., Nesterov S.N., Hanaliev B.V., Kosarev E.I., Barsegyan A.G., Volodichev V.V. Erectile dysfunction and urinary incontinence associated with robot-assisted prostatectomy. Bulletin of Pirogov National Medical & Surgical Center. 2019;2(14):59-62. (In Russ.) https://doi.org/10.25881/BPNMSC.2019.86.92.013