Postoperative orgasmic function increases over time in patients undergoing nerve-sparing radical prostatectomy

Andrew Salonia, Andrea Gallina, Alberto Briganti, Renzo Colombo, Roberto Bertini, Luigi F. Da Pozzo, Giuseppe Zanni, Antonio Sacca, Lorenzo Rocchini, Giorgio Guazzoni, Patrizio Rigatti, Francesco Montorsi

Research output: Contribution to journalArticlepeer-review


Introduction: Postprostatectomy orgasmic function (OF) remains poorly defined. Aims: To assess OF over time in patients who underwent bilateral nerve-sparing radical retropubic prostatectomy (BNSRRP) for organ-confined prostate cancer (PCa). Methods: Baseline data were obtained from 334 consecutive preoperatively sexually active PCa patients at hospital admission; data included a medical and sexual history, IIEF domain scores, and ICIQ-SF. Questionnaire were then completed every 12 months postoperatively, and patients participated in a semistructured interview at the 12-month (191/334 [57.2%] patients), 24-month (95/334 [28.4%] patients), 36-month (42/334 [12.6%] patients), and 48-month (19/334 [5.7%] patients) follow-up (FU). Main Outcome Measures: IIEF-OF domain values throughout the FU. Multivariate linear regression analysis (MVA) of the association between predictors (patient's age, IIEF-erectile function [EF], ICIQ-SF, and the use of postoperative proerectile pharmacological treatments) and the IIEF-OF at 12-month, 24-month, and 36-month FU. Results: Preoperative mean (median) IIEF-OF was 7.6 (10). The anova analysis showed an increase of the IIEF-OF values (P = 0.008; F = 4.009) throughout the FU (namely, IIEF-OF 12-month: 6.1 [6]; 24-month: 7.2 [8]; 36-month: 7.3 [8]; and 48-month: 7.7 [9.50]). The 12-month MVA showed that while proerectile oral therapy did not affect postoperative OF (P = 0.150; Beta 0.081), IIEF-OF linearly increased with IIEF-EF (P <0.001; Beta 0.425). Conversely, IIEF-OF linearly decreased with patient's age (P <0.001; Beta -0.135) and with ICQ-SF scores (P <0.001; Beta -0.438). The 24-month and 36-month analyses showed that IIEF-OF still linearly increased with IIEF-EF (P <0.001; Beta 0.540, and P <0.001; Beta 0.536 respectively at the 24- and 36-month FU), whereas pharmacological therapy, rate of urinary continence, and patient's age did not significantly affect postoperative OF. Conclusions: Postoperative OF significantly ameliorates over time in patients undergoing BNSRRP. The higher the postoperative EF score, the higher the OF throughout the FU time frame.

Original languageEnglish
Pages (from-to)149-155
Number of pages7
JournalJournal of Sexual Medicine
Issue number1 PART 1
Publication statusPublished - Jan 2010


  • Follow up
  • Orgasm
  • Orgasmic function
  • Prostate cancer
  • Prostatectomy

ASJC Scopus subject areas

  • Urology
  • Obstetrics and Gynaecology
  • Reproductive Medicine


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