(PM-13) Comparison between open and laparoscopic radical prostatectomy regarding postoperative erectile function in a tertiary Hospital in Curitiba

Abstract Introduction Erectile dysfunction (ED) is one of the most prevalent complications following radical prostatectomy. Despite advances in surgical techniques, the impact on sexual function remains controversial. Some studies suggest that the laparoscopic approach may be associated with lower morbidity, but the difference in terms of ED remains debatable. Objective To compare the occurrence of postoperative erectile dysfunction between patients undergoing open versus laparoscopic radical prostatectomy. Methods A retrospective cohort study was conducted including 115 patients who underwent radical prostatectomy between March 2018 and March 2023 (open = 48; laparoscopic = 67). Erectile function was assessed three months postoperatively through a direct question to the patient (normal or impaired erectile function). Statistical analyses were performed considering p < 0.05 as statistically significant. Results There was no significant difference in ED rates between the two groups. Even after excluding patients with any degree of pre-existing ED (n = 102), the difference remained non-significant (Open: 54% vs. Laparoscopic: 60%, p = 0.56). Additionally, comorbidity count, BMI, and BMI categories did not significantly impact the presence of ED. No cases were performed using a nerve-sparing technique. Conclusion The surgical approach (open vs. laparoscopic) was not significantly associated with postoperative erectile dysfunction, although a higher incidence was observed in the laparoscopic group. These findings suggest that other clinical and anatomical factors may play a more decisive role in postoperative erectile function. Financing No conflict.