(PNM-25) Impact of surgical technique on therapeutic response for erectile dysfunction following radical prostatectomy in a tertiary Hospital in Curitiba

Abstract Introduction Erectile dysfunction (ED) is one of the most relevant functional complications following radical prostatectomy, significantly affecting patients’ quality of life. While numerous studies have investigated its incidence, less attention has been given to the therapeutic response to pharmacological treatment in different surgical contexts. The surgical approach, particularly laparoscopic prostatectomy, has been associated with reduced tissue trauma and better neurovascular preservation, which could positively influence erectile function recovery and subsequent treatment efficacy. Objective To investigate the association between the type of radical prostatectomy (open vs. laparoscopic) and the resolution of erectile dysfunction with pharmacological treatment. Methods A retrospective cohort study was conducted including patients who underwent radical prostatectomy between March 2018 and March 2023. The rates of ED resolution with pharmacological treatment were compared between surgical approaches (open vs. laparoscopic). Results A statistically significant association was found between the surgical approach and the therapeutic response to erectile dysfunction with PDE5i (p = 0.012). Among patients who underwent laparoscopic prostatectomy, 15 out of 38 (39.5%) achieved resolution of ED with medication, compared to only 3 out of 27 (11.1%) in the open surgery group, indicating a higher likelihood of treatment response in those undergoing the laparoscopic technique. Conclusion Laparoscopic radical prostatectomy was associated with a significantly higher rate of erectile dysfunction resolution with pharmacological treatment. These findings suggest that the choice of surgical technique may influence not only the occurrence of dysfunction but also its treatment response, highlighting the potential functional advantages of the laparoscopic approach. Financing No conflict.