Erectile Recovery After Radical Pelvic Surgery: Methodological Challenges and Recommendations for Data Reporting |
| |
| Affiliation: | 1. Division of Experimental Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Milan, Italy;2. Università Vita-Salute San Raffaele, Milan, Italy;3. Portsmouth Hospitals NHS Trust, Portsmouth, UK;4. University of Portsmouth, Portsmouth, UK;5. Department of Urology, L’Institut Mutualiste Montsouris, Paris, France;1. Department of Urology, Columbia University, New York, NY, USA;2. Department of Urology, Department of Biostatistics, Columbia University, New York, NY, USA;3. Chief, Reconstructive Urology, Given Foundation Professor of Urology, Columbia University Medical Center, New York, NY, USA;1. Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria;2. Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA;3. Institute of Outcomes Research, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria;4. Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria;5. Department of Behavioural Science and Health, University College London, London, UK;6. Division of Psychology, School of Psychology and Sports Sciences, Anglia Ruskin University, Cambridge, UK;7. Centre for Psychological Medicine, Perdana University, Serdang, Malaysia;8. Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK;9. Department of Epidemiology, Centre for Public Health, Medical University of Vienna, Vienna, Austria;1. Department of Social and Organizational Psychology, Instituto Universitário de Lisboa (ISCTE-IUL), CIS-IUL, Lisbon, Portugal;2. Faculty of Psychology and Education Sciences, University of Coimbra, Portugal;1. Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China;2. Department of Urology, Jiangsu Provincial People’s Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing, China;3. Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China;4. Department of Andrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, China;5. Department of Psychiatry, Nanjing Brain Hospital, Affiliated Hospital of Nanjing Medical University, Nanjing, China;6. Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China;1. George Washington University, Washington, DC, USA;2. University of Virginia School of Medicine, Charlottesville, Virginia, USA;3. Weill Cornell Medical College, New York, New York, USA;4. Albert Einstein College of Medicine, Yeshiva University, New York, New York, USA;5. Stanford University School of Medicine, Stanford, California, USA |
| |
| Abstract: | IntroductionErectile function (EF) outcomes after radical pelvic surgery vary widely among different studies, partly as a consequence of heterogeneity with regard to the data assessment and reporting methodology.AimReview the methodology of data assessment and reporting of studies evaluating EF outcomes after radical prostatectomy (RP), radical cystectomy (RC), and rectal surgery (RS) and provide detailed recommendations to conduct future high-quality research.MethodsThe MEDLINE database was searched for randomized clinical trials and open-label prospective or retrospective studies.Main Outcome MeasureThe panel reviewed the modality of data assessment and reporting concerning 3 specific areas: preoperative patients assessment, surgical technique description, and postoperative patients management and follow-up.ResultsOverall, 280, 36, and 73 studies investigating EF after RP, RC, and RS, respectively, were included. Baseline EF was largely reported (88%) in studies on RP, but only 67% of the studies on either RC or RS assessed EF before surgery. Baseline comorbidities that could impact postoperative EF were reported in 62%, 64%, and 85% of studies on RP, RC, and RS, respectively. The type of surgical approach was provided in all studies, and surgical details relevant to EF (eg, nerve- or organ-sparing surgery) were reported by 86%, 81%, and 62% of studies on RP, RC, and RS, respectively. Conversely, surgeon experience was rarely reported across all studies. Validated tools were commonly used to assess postoperative EF (64% of studies for RP, 78% for RC, and 71% for RS). Only 41%, 17%, and 29% of studies on RP, RC, and RS, respectively, reported a follow-up of at least 2 years. Use of erectile dysfunction treatment after surgery was assessed by only 39%, 17%, and 4.1% of studies on RP, RC, and RS, respectively. Factors potentially influencing EF recovery (eg, urinary or fecal continence, urinary diversion) were commonly reported, but sexual desire after surgery was reported by only 18%, 42%, and 37% of studies on RP, RC, and RS, respectively.Clinical ImplicationsThe use of a shared methodology for the assessment and reporting of data on EF outcomes after pelvic surgery would allow better estimation of EF outcomes after pelvic surgery.Strengths & LimitationsThe modality of data assessment and reporting among studies investigating EF outcome after pelvic surgery was systematically investigated to provide recommendations allowing a proper interpretation of data.ConclusionStudies on EF outcomes after radical pelvic surgery should fulfill specific criteria concerning preoperative patient assessment, reporting of surgical details, and postoperative functional outcome evaluation and management.Capogrosso P, Pozzi EP, Celentano V, et al. Erectile Recovery After Radical Pelvic Surgery: Methodological Challenges and Recommendations for Data Reporting. J Sex Med 2020;17:7–16. |
| |
| Keywords: | Erectile Dysfunction Radical Prostatectomy Prostate Cancer Erectile Function Recovery |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
