Our Summary

The researchers used a new review method, called reverse systematic review, to examine how different ways of classifying erectile dysfunction can affect how often it occurs in patients who have had a specific type of prostate surgery (laparoscopic radical prostatectomy).

They looked at studies from 2000 to 2020 that used the most common classification methods and checked erectile dysfunction rates at 1, 3, 6, 12, and 18 months after surgery. The methods fell into four groups: “Erection Sufficient for Intercourse (ESI)”, “IIEF-5 > 17”, “IIEF-5 > 22” and “Not Available”. They analyzed the data to find patterns over time.

They looked at 40 reviews that included 21,618 patients. They found that ESI was the most commonly used classification method (75.3%) followed by IIEF-5 > 22 (11.1%). Even though ESI is simpler, it showed higher rates of erectile dysfunction at 1, 3, 6 and 12 months (8%, 27%, 43% and 51%) when compared to IIEF-5 > 22 (14%, 26%, 45% and 58%). The studies were published between 2005 and 2015, but ESI became the main method used in 2010, which led to less use of other methods.

The researchers concluded that the reverse systematic review was successful in showing how different classification methods for erectile dysfunction have been used over time in relation to this type of prostate surgery. They found that simpler methods, like ESI, were more frequently used, despite showing higher rates of erectile dysfunction compared to other methods.

FAQs

  1. What is a reverse systematic review and how was it used in this research?
  2. How do different methods of classifying erectile dysfunction affect its occurrence in patients who underwent laparoscopic radical prostatectomy?
  3. What was the most commonly used classification method for erectile dysfunction in the reviewed studies and what were its implications on the reported rates of erectile dysfunction post-surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about prostatectomy is to discuss with your healthcare provider the different ways erectile dysfunction can be classified after surgery. Understanding the classification methods and their implications can help you better manage and cope with any potential erectile dysfunction issues post-prostatectomy. It is important to have open and honest communication with your healthcare team to address any concerns or questions you may have.

Suitable For

Patients who have undergone laparoscopic radical prostatectomy are typically recommended prostatectomy if they are experiencing erectile dysfunction. The classification methods used to determine erectile dysfunction rates post-surgery include “Erection Sufficient for Intercourse (ESI)”, “IIEF-5 > 17”, and “IIEF-5 > 22”. Patients who fall into these categories may benefit from prostatectomy to address their erectile dysfunction issues.

Timeline

Before prostatectomy:

  • Patient is diagnosed with prostate cancer and discusses treatment options with their healthcare provider.
  • Patient decides to undergo a prostatectomy, a surgical procedure to remove the prostate gland.
  • Patient may undergo preoperative testing and counseling to prepare for the surgery.
  • Patient may experience anxiety and uncertainty about the surgery and potential side effects, including erectile dysfunction.

After prostatectomy:

  • Patient undergoes the prostatectomy surgery.
  • Patient may experience pain, discomfort, and side effects from the surgery.
  • Patient may be monitored closely in the hospital for a few days post-surgery.
  • Patient may experience urinary incontinence and erectile dysfunction as common side effects of the surgery.
  • Patient may participate in postoperative rehabilitation and counseling to address these side effects.
  • Patient may gradually see improvements in urinary and sexual function over time, with some patients experiencing long-term erectile dysfunction despite treatment.
  • Patient may undergo follow-up appointments and monitoring to track their recovery and address any ongoing concerns.

What to Ask Your Doctor

  1. What is the likelihood of experiencing erectile dysfunction after a laparoscopic radical prostatectomy?

  2. How is erectile dysfunction typically classified after this type of surgery?

  3. What are the differences between the classification methods Erection Sufficient for Intercourse (ESI), IIEF-5 > 17, and IIEF-5 > 22 in terms of predicting erectile dysfunction outcomes?

  4. How does the classification method used for erectile dysfunction impact the reported rates of erectile dysfunction at different time points post-surgery?

  5. Are there any specific factors that may influence the likelihood of experiencing erectile dysfunction after a prostatectomy?

  6. What are the potential treatment options for erectile dysfunction following a prostatectomy?

  7. How often should I follow up with you or a specialist regarding erectile dysfunction after my surgery?

  8. Are there lifestyle changes or interventions that may help improve erectile function after a prostatectomy?

  9. What are the potential risks or complications associated with treating erectile dysfunction post-prostatectomy?

  10. Are there any clinical trials or emerging treatments for erectile dysfunction in patients who have undergone a prostatectomy that I should be aware of?

Reference

Authors: Moretti TBC, Capibaribe DM, Avilez ND, Neto WA, Reis LO. Journal: Int Urol Nephrol. 2022 Sep;54(9):2097-2104. doi: 10.1007/s11255-022-03262-w. Epub 2022 Jun 28. PMID: 35764756