Erectile function after cystectomy with neurovascular preservation.

Objectives: To study the utility of neurovascular preservation for postoperative erection in radical cystectomy.
Materials and Methods: Retrospective analysis of 44 cystectomies performed at our center between January 2006-December 2009 in men <65 years. In 11 cases a neurovascular preservation was done. We analyzed age, BMI, indication for surgery, urinary diversion, use of i-PDE5 or alprostadil, and daytime and nighttime continence. Erection Hardness Score (EHS) was used to assess erectile function.
Results: Spontaneous postoperative erectile function in preservation group was 44,4% EHS 4, 33,3% EHS 3 and 22,3% EHS 1 (achieving EHS 3 or 4 with alprostadil). In the non preservation group, 4,5% achieved EHS 4 spontaneously. The other 95,5% had EHS 0 (4,5% achieved EHS 3 with tadalafil 20 mg and 9% with intracavernous injections). Variables age (P=.001) and nerve-sparing surgery (P<.001) were related to postoperative erectile function recovery. In the multivariate analysis, nerve-sparing surgery remained statisticaly significant.
Conclusions: The functional results in preserving cystectomy are promising. The preservation should be considered in young patients without erectile dysfunction.
(Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.)