| Objective:Prostate cancer is one of the most common malignant tumors of the male genitourinary system.The clinical treatment effect of early patients is good.The patient had three consecutive wins after surgery,namely the tumor control,urination control and erectile function protection,people always pay mo re attention to the first two,but with the development of technology and theory innovation,erectile function after radical resection of the prostate cause attention gradually.By analyzing the related factors of erectile dysfunction after radical prostatectomy,this study explored the effective methods to promote the recovery of erectile dysfunction after radical prostatectomy,and established a linear prediction model for verification,aiming to provide better diagnosis and treatment for promoting the recovery of erectile function of patients after radical prostatectomy.Methods:The data of 88 patients with limited prostate cancer hospitalized at the People’s Hospital of Jiangxi Province and the First Affiliated Hospital of Nanchang University from October 2018 to October 2020 were retrospectively analyzed,and all patients underwent radical prostatectomy with postoperative pathologically confirmed PCa(T1 to T2),and all patients met the inclusion and exclusion criteria,of which 76 cases were analyzed for data and prediction models,and the other The prediction model was validated in 12 cases.Data on age,prostate volume,PSA,Gleason score,clinical stage,duration of surgery,surgical modality(including robotic or laparoscopic surgery),and nerve preservation modality(intrafascial or interfascial nerve preservation surgery)were collected and analyzed in groups for each of the 76 patients.Patients’ erectile function was assessed preoperatively and 12 months postoperatively by the IIEF-5 scale and Rigiscan examination,respectively.A univariate analysis was used to analyze the factors associated with the patients’ postoperative erectile dysfunction,while further multifactorial logistic regression was taken to analyze the independent correlates of the patients’ postoperative erectile function.The Nomogram prediction model of erectile dysfunction after radical prostate cancer treatment was drawn by R software,and the data of 12 additional patients were validated.Results:In this study,76 patients with radical prostate cancer were included,with patient ages ranging from 46 to 76 years,mean age(65.57±6.68)years,PSA(20.49±14.60)ng/ml,prostate volume(46.06±14.39)ml,operative time(133.43±53.31)min,mean preoperative IIEF-5 The mean preoperative IIEF-5 score was(20.91±2.74)and the mean postoperative IIEF-5 score was(16.18±4.74).35 patients underwent robotic-assisted radical prostatectomy and the other 41 patients underwent laparoscopic radical prostatectomy.Regarding the intraoperative surgical approach to preserve erectile function,40 patients underwent intrafascial nerve-preserving surgery and 36 patients underwent interfascial nerve-preserving surgery.Postoperatively,according to the patients’ IIEF-5 scores and Rigiscan examination,the results showed that erectile dysfunction occurred in 39 patients 12 months after surgery and 37 patients had normal erectile function after surgery.The results of univariate analysis showed that patient age,PSA,prostate volume,time of surgery,surgical method,and surgical method of preserving the sexual nerve were significantly associated with erectile dysfunction after radical prostate cancer surgery(P < 0.05),and further multifactorial binary logistic regression analysis was taken to show that patient age,prostate volume,surgical method,and surgical method of preserving the sexual nerve were independent correlated factors.In the Nomogram prediction model established with this model,the AUC value of the model was 0.743.Another 12 cases were validated and the prediction results were consistent with the final results in 9 cases,and the predictive validity of the model was high.Conclusions:1.In this study,age,prostate volume,surgical approach and sexual nerve preservation approach were independent correlates of erectile dysfunction after radical prostate cancer surgery in patients.2.The results of this study showed that for PSA,time to surgery,Gleason score and clinical stage have not been found to be significantly associated with erectile dysfunction after radical prostate cancer surgery.3.The four independent correlated factors mentioned above were developed into a column line graph prediction model,and the prediction model has high predictive validity,which can be used to assess the risk of ED occurrence after RP and provide some reference for promoting erectile function recovery after RP. |
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