The Use of Validated Quality of Life Questionnaire to Assess the Return of Sexual Function Following Laparoscopic Radical Prostatectomy (LRP)

Andrew A Wagner, Richard E Link, Wendy Sullivan, Christian P Pavlovich, Li-Ming Su
Johns Hopkins University, Baltimore, MD

Introduction:
Wide variations exist in the methods for reporting potency following radical prostatectomy. We used validated questionnaires to assess relative return to normal sexual function following nerve-sparing (NS) LRP.
Methods:
Sexual function was evaluated using EPIC questionnaires and single-question assessment of sexual intercourse. Data was obtained preoperatively and at 3, 6, and 12 months postoperatively. Each patient’s baseline EPIC sexual function subdomain score (SFSS) was normalized to 100% and postoperative SFSS reported as a percentage of baseline function.
Results:
220 men underwent LRP by 2 surgeons. 164/220 (75%) reported preoperative intercourse and are the focus of this analysis. 88% of this patient subset underwent nerve-sparing surgery (59% bilateral and 29% unilateral). For this cohort, 68% had 6 month EPIC data and 38% had 12 month data available for analysis. Using single question analysis, 72% and 35% of those undergoing bilateral and unilateral NS reported intercourse at 12 months respectively. This disparity was not reflected, however, in mean SFSS at 12 months (bilateral NS: 61% of baseline; unilateral NS: 57%, p=0.710). Of all patients receiving NS, 76% of patients ≤ 58 years of age and 46% >58 reported intercourse at 12 months (p=0.021). Mean SFSS were 61% and 41% at 6 months (p=.011), and 62% and 59% at 12 months (p=0.85) for patients ≤ 58 and > 58 years of age respectively.
Conclusions:
Our results provide surgeon and patient with a realistic forecast of relative return to normal sexual function following LRP based on age, preoperative function, and nerve sparing status.

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