Presentation Authors: Abhinav Khanna*, Anna Faris, Anna Zampini, Daniel Hettel, Hadley Wood, Bradley Gill, Edmund Sabanegh, Cleveland, OH
Introduction: Radical prostatectomy significantly affects male sexual function. This study assessed the impact of pre-operative group education on preparedness for surgery and post-operative patient-reported sexual function outcomes.
Methods: A group education seminar was offered to men undergoing radical prostatectomy between 2015-2017. Seminars were led by advanced practice providers with experience caring for men following prostatectomy. Patients were counseled on the expected perioperative course, including erectile dysfunction and expectations for sexual recovery. Patients completed surveys at baseline as well as by telephone at 3-weeks, 3-months, 6-months and 1-year post-operatively.
Results: A total of 210 men underwent group education before prostatectomy. Of 147 men with intact baseline erectile function, follow-up surveys were completed by 92 (62.6%) at 3 weeks, 69 (46.9%) at 3 months, 48 (32.7%) at 6 months, and 36 (24.5%) at 1 year post-operatively. The proportion of men with partial or full erections increased over time from 20.7% at 3 weeks to 58.3% at 1 year (Figure 1). Conversely, the proportion reporting post-operative erectile function &[Prime]as expected&[Prime] or better decreased from 56.8% at 3 weeks to 11.8% at 1 year. Notably, men who reported greater pre-operative understanding that surgery may worsen erections were more likely to report their erections &[Prime]as expected&[Prime] or better after surgery (52.5% vs 0% at 3 months, p=0.006). Similarly, men who were most &[Prime]prepared overall&[Prime] before surgery were more likely to rate their erections &[Prime]as expected&[Prime] or better following prostatectomy (45.2% vs 0% at 6 months, p=0.003). Of note, among men with no erectile recovery, the proportion reporting erections &[Prime]as expected&[Prime] decreased from 48.5% at 3 weeks to 0% at 1 year (p < 0.05).
Conclusions: Despite increased recovery of erections through 1 year after prostatectomy, patient-reported satisfaction with post-operative erectile function decreased over time. However, men with greater preparedness for surgery had better post-operative patient-reported sexual function relative to expectations. Increasing preparedness for prostatectomy by setting accurate expectations with preoperative education is associated with improved patient-reported sexual function outcomes.