Table 3.
Selected Studies Examining Intermediate- (≥2-Year) and Long-term (≥10-Year) Sexual and EF in Patients Undergoing RP for Clinically Localized Prostate Cancer
| Study | Length of Follow-up (y) | Study Design (Baseline?) | Number of Patients Outcome Measure | Results | |
|---|---|---|---|---|---|
| Intermediate-term Studies (≥2 y) | |||||
| Huang GJ et al18 | 4 | Prospective, longitudinal (no baseline) | 1269 | UCLA-PCI-SFI | Gradual improvement in UCLA-PCI-SFS from 1–4 y |
| Glickman L et al49 | 4 | Prospective, longitudinal (baseline) | 731 | Self-report | 42% report subjective improvement in EF and 4% report deterioration in EF from 2–4 y |
| Rabbani F et al131 | 5 | Prospective, longitudinal (baseline recalled) | 136 | Nonvalidated 5-point EF scale | 8%, 20%, and 23% experienced improvement in EF at 3, 4, and 5 y, respectively |
| Penson DF et al134 | 5 | Population-based, prospective, longitudinal (baseline) | 1288 | Items adapted from previously validated and reliable instruments | At 5 y, 28% had EF adequate for sexual intercourse, compared with 22% at 2 y Decreasing sexual bother from 2–4 y |
| Parker WR et al68 | 5 | Prospective, longitudinal (baseline) | 361 | EPIC Sexual Domain | Sexual function stable from 2–5 y |
| Sexual bother returns to baseline by 3 y but does not improve afterward | |||||
| Miller DC et al38 | 6.2 (median) | Prospective, longitudinal cohort (no baseline) | 964 (665 RP) | EPIC Sexual Domain | EPIC scores stable from median 2.6–6.2 y |
| Long-term Studies (≥10 y) | |||||
| Sivarajan G et al135 (NYUPLOS) | 10 | Prospective, longitudinal (baseline) | 1785 | UCLA-PCI-SFI | UCLA-PCI-SFS stable from 2–8 y, with a slight decline from 8–10 y |
| Qualitative improvements in EF in 35.9% and 19.9% between 2–4 y and 5–7 y, respectively | |||||
| Resnick MJ et al51 (PCOS) | 15 | Prospective, longitudinal (baseline recalled) | 1164 | Items adapted from previously validated and reliable instruments ED = EF inadequate for sexual intercourse | ED in 13% at 5 y and 24% at 15 y (P unknown) Men with RP more likely than men with RT to have ED at 2 y (OR 3.46; 95% CI, 1.93–6.17) and 5 y (OR 1.96; 95% CI, 1.05–3.63), but no significant difference at 15 y |
CI, confidence interval; ED, erectile dysfunction; EF, erectile function; EPIC, Expanded Prostate Cancer Index Composite; NYUPLOS, New York University Prospective Longitudinal Outcomes Study; PCOS, Prostate Cancer Outcomes Study; OR, odds ratio; RP, radical prostatectomy; RT, radiotherapy; UCLA-PCI-SFI, UCLA Prostate Cancer Index Sexual Function Index; UCLA-PCI-SFS, UCLA Prostate Cancer Index Sexual Function Score.