Self-healing? Improvements in erectile and urinary function after prostatectomy

This study looked at the possibility of long-term improvements in urinary function or erectile function after prostate gland removal (radical prostatectomy).

Radical prostatectomy (RP) is the most common treatment for prostate cancer, but this treatment can cause urinary and erectile problems.  A common assumption has been that if urinary function or erectile function was not regained within 12 months of RP, then the chance of recovery was very low. However, it is not clear from previous research whether or not this assumption is true.

The current study examined whether erectile and urinary function improved in the long-term following RP.

The study involved 800 patients who reported urinary dysfunction 12 months following RP, and 1003 patients who reported erectile dysfunction. Each patient completed a standardized survey around 12 months after the RP, and then again around 24 months, 36 months and 48 months. The patients rated their urinary function or erectile function each time using a scoring method designed to measure quality of life.

Among patients who were incontinent (unable to control urination) at 12 months, the likelihood of achieving good urinary function at 24 months was 30%, 49% at 36 months, and 59% at 48 months. Among patients experiencing erectile problems at 12 months, the likelihood of achieving good erectile function at 24 months was 22%, 32% at 36 months, and 40% at 48 months.

The probability of recovery for both urinary function and erectile function was significantly influenced by the level of functionality at 12 months after RP.

This study concluded that long-term recovery from urinary or erectile dysfunction after RP is possible. This study also suggested that recovery is influenced by the patient’s urinary or erectile capability at 12 months after RP.

This study focused on subjects from one institution only. The standard of follow-up care in institutions is likely to differ and affect outcomes. 

If you are experiencing urinary or erectile problems following RP, you should discuss this with your doctor to help make decisions on the best rehabilitation care for you.