Erythropoietin promotes erection recovery after nerve-sparing radical retropubic prostatectomy: a retrospective analysis.

Introduction: Erectile dysfunction persists as a major functional complication of nerve-sparing radical prostatectomy.
Aim: To evaluate retrospectively the potential benefit of erythropoietin administration to improve erectile function recovery following radical prostatectomy.
Methods: Preoperatively potent patients who underwent nerve-sparing radical retropubic prostatectomy between March 2005 and February 2006 elected to receive erythropoietin treatment (40,000 IU subcutaneously, single injection on their preoperative day; treatment group, N = 15). A contemporaneous clinically matched cohort comprising patients who elected postoperative standard surveillance only served for comparison (control group, N = 21). Phosphodiesterase type 5 (PDE5) inhibitor "on-demand" use was applied. Potency evaluations were monitored by International Index of Erectile Function-5 questionnaires administered preoperatively and at 3, 6, and 12 months postoperatively.
Main Outcome Measure: Erection recovery.
Results: Health comorbidities as well as erectile function status were demonstrated to be no different between groups at baseline. Erythropoietin-treated patients demonstrated significantly higher postoperative International Index of Erectile Function-5 questionnaire scores than control group patients at 3, 6, and 12 months postoperatively with or without use of PDE5 inhibitors (P < 0.05). At 12 months postoperatively, the percentages of patients performing sexual activity were 87% and 68% of erythropoietin-treated and control patients, respectively (P = 0.213), although the erythropoietin-treated patients had a significantly greater ability to perform sexual intercourse with minimal or no difficulty (P < 0.05).
Conclusion: Erythropoietin administration on the preoperative day before undergoing nerve-sparing radical prostatectomy in men reporting normal erectile function preoperatively may confer improved erectile function recovery postoperatively.