Risk of impotence after prostate surgery higher than thought, study says

PROSTATE CANCER: description risk symptoms treatment prevention Choose a link above to learn more about prostate cancer. Source: WebMD   IMPOTENCE: description risk symptoms treatment prevention Choose a link above to learn more about impotence. Source: WebMD

January 18, 2000
Web posted at: 2:15 p.m. EST (1915 GMT)

(CNN) -- It has long been known sexual dysfunction is a risk associated with the surgical removal of the prostate gland. However a new study in the Journal of the American Medical Association finds the risk may be higher than previously thought.

When Ellis Corets, 69, was diagnosed with prostate cancer six years ago, he had to choose between radiation treatment, just waiting, and radical prostatectomy -- the complete removal of his prostate gland.

Corets opted for the radical prostatectomy. Like most men, he was told his chance of impotence from the procedure was 20 to 30 percent, but the JAMA study found the risk to be twice that.

"We found that overall, about 60 percent of men reported at 18 or months after surgery -- and this was after they had a chance to recover from surgery -- told us that they were unable to have sexual intercourse because their erections were inadequate," said Dr. Janet Stanford of Fred Hutchinson Cancer Research Center.

Men who underwent a special nerve-sparing procedure didn't fare much better.

Experts attribute this difference in numbers to the type of studies previously conducted. Past studies have been based on experiences with individual institutions and surgeons, not the general population.

"In highly technical surgical procedures, one is always best served by having it done, having it performed by somebody who has had a lot of time in the pilot seat, who's basically adept at all the nuances and the potential complications," said Dr. Natan Bar-Chama of Mt. Sinai Hospital in New York.

The JAMA study, a population-based study, also found that certain groups of men did better than others.

"In particular, men with more education, higher incomes tended to fare better," Stanford said. "In addition, we found the younger men recovered more fully and they recovered earlier than older men in this study."

But experts say while impotence is upsetting, it not untreatable.

MESSAGE BOARD Prostate cancer   DOCTOR Q&A: Read what doctors say about Viagra and impotence or ask your own questions.

"There are patients that might respond to Viagra, which is an oral medication and there soon might be other medications available on the market," Bar-Chama said.

Despite the side effects, about half of the men surveyed said they were delighted or pleased with the surgery. And 18 months later, 71 percent said they would make the same choice again.

But researchers say doctors can do better by giving patients a more accurate assessment of risk, so that they can make a more informed decision.