Long road to restore sexual satisfaction after RARP

It may take a long time to recover sexual satisfaction in men after robot-assisted radical prostatectomy (RARP), a new study has found.

Accessing a prospectively maintained database of prostate cancer patients, the researchers assessed outcomes in 884 men who had undergone RARP and who had available erectile function data; those with erectile dysfunction (ED) at baseline were excluded. Postoperative ED, as well as sexual desire and satisfaction, were assessed using the International Index of Erectile Function (IIEF) questionnaire.

At baseline, men without ED had a mean sexual satisfaction score of 8.2±1.7. Those who developed ED due to RARP scored a satisfaction average of 4.8 points at the 6-month follow-up. Values were relatively stable after 12, 24, and 36 months of follow-up (mean scores: 4.8, 4.9, and 4.6, respectively).

In contrast, those who did not have postoperative ED scored significantly higher, earning averages of 8.4, 8.4, 8.1, and 8.2 at 6, 12, 24, and 36 months of follow-up, respectively (p<0.01).

Multiple logistic regression analysis showed that those who had higher overall satisfaction scores at baseline were nearly 50-percent more likely to have better satisfaction after 24 months of follow-up (odds ratio [OR], 1.4, 95 percent confidence interval [CI], 1.1–1.8; p=0.01). The same was true for men who had higher sexual desire at 24 months (OR, 1.7, 95 percent CI, 1.4–2.1; p<0.01).

“Satisfaction with sexual life in men with ED due to RARP did not improve between 6 and 36 months’ follow-up, indicating improvement of satisfaction might take a long time,” the researchers said.

“One could counsel patients that sexual satisfaction is based on individual baseline sexual satisfaction and the return of sexual desire after RARP. It is vital to present realistic, individualized expectations regarding both sexual satisfaction and recovery after RARP,” they added.