Risikofaktoren der postoperativen erektilen Dysfunktion nach radikaler nerverhaltender Prostatektomie

A inevitable consequence of radical prostatectomy without nerve protection is the total erectile dysfunction. With nerve protection the risk of erectile dysfunction can be lowered but not eliminated. Preoperative counselling of patients can be optimised in cognition of the factors which influence the postoperative erectile function. 110 Patients were asked 18-24 months after the operation with regard to their erectile potence. This patients were separated in the four groups of the erection hardness score, which assses the rigidity of their erections. Different potential risk factors (age, quality of preoperative erections, PSA-value in serum, Gleason score, tumor volume, prostate volume, adjuvant radiotherapy, nicotine consuming, ASA-score, chronic disease score [CDS], hypertension, hypercholesterolaemia, diabetes mellitus, coronary heart disease) of postoperative erectile function was correlated in univariate analysis. For the multivariate analysis were the factors used with univariate correlation (p <= 0.05) or with tendentially relation (p <= 0.2) to the postoperative function. On univariate analysis, age (p < 0.001) and ASA-score (p = 0.018) were negative predictors of postoperative potency. On multivariate analysis, only age revealed significance (p = 0.028). Being one year older the patients’ risk of an erectile status one grade lower is increased by factor 1.128. Being ten years older, the risk of a worse functional outcome is increased by factor 3.334. In case of an age difference of 20 years,the factor is nearly 11