Cornell University researchers have shown that most men can still reach orgasm after robot-assisted laparoscopic radical prostatectomy (RALP), as long as the nerves around the prostate are spared.
The study was published in the February issue of BJUI.
Nerve-sparing and a man’s age are key factors, the authors said.
Nerves are located on both sides of the prostate gland. During RALP, surgeons try to avoid cutting nerves in order to preserve a man’s sexual function. However, sometimes cutting nerves is unavoidable because of a tumor’s location or the path taken by spreading cancer.
The study had 408 participants, all of whom could have intercourse and reach orgasm before their RALP procedure. All of them scored 60 points or more on the International Index of Erectile Function, a tool that assesses erectile ability. The group’s median age was 60.
74% of the men had bilateral nerve sparing (retaining nerves on both sides). 13.5% had unilateral nerve sparing (with one side of nerves retained) and 12.5% had little or no nerve sparing.
Overall, 88.4% of the men age 60 and under were able to reach orgasm after their RALP procedure. 80% of them said their orgasms were the same as they were before surgery. 12% were not able to reach orgasm at all.
82.6% of the men over age 60 could achieve orgasm after surgery. Of this group, 80% reported the same orgasm as before and 17% were not able to reach orgasm.
The degree of nerve-sparing was important. 93% of the men under age 60 who had had bilateral nerve sparing could reach orgasm post-RALP. This number dropped to 83% for men under 60 who had had unilateral nerve sparing and 65% for men under 60 who had had no nerve sparing.
“As far as we are aware, this is the largest analysis of orgasmic function in the robotic prostatectomy literature and will provide valuable information for surgeons talking to patients about what sort of sexual function they can expect after surgery,” said Dr. Ashutosh Tewari, the study’s lead author, in a press release.
Dr. Tewari is the Director of the Prostate Cancer Institute and the LeFrak Robotic Surgery Center at Weill Cornell Medical College.
Resources
BJUI
“Nerve sparing helps most prostate cancer patients to have same orgasms as before surgery”
(Press release – February 13, 2012)
http://www.bjui.org/BJUI_IMAGES/Nerve%20sparing%20PRESS%20RELEASE%20February%202012.pdf
Tewari, Ashutosh, et al.
“Nerve sparing can preserve orgasmic function in most men after robotic-assisted laparoscopic radical prostatectomy”
(Abstract – first published online August 18, 2011)
http://onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2011.10402.x/abstract
HealthDay
“Nerve-Sparing Prostate Surgery Helps Men Retain Sexual Function”
(February 16, 2012)
http://consumer.healthday.com/Article.asp?AID=661750
Sexual Medicine Society of North America
“Nerve-sparing Prostate Surgery & Orgasms”
(March 16, 2012)
http://www.sexhealthmatters.org/news/nerve-sparing-prostate-surgery-orgasms