Evaluation of changes of cavernousal hemodynamics in erectile dysfunction amongst the localize prostate cancer diagnosed and radical retropubic prostatectomy operated patients

The aim of this study was to evaluate preoperative and postoperative erectile dysfunction of prostate cancer diagnosed and RP operated patients, explore the effects of arterial and venous injury during surgery on erectile dysfunction.For this purpose, 20 patients that diagnosed with localized prostate cancer and have normal preoperative erectile function were evaluated.erectile dysfunctions of patients were evaluated with the IIEF questionnaire and penile doppler ultrasound done with 50 mg of papaverine.Mean IIEF scores were recorded as 21,78 (22-25) and no preoperative erectile dysfunction was determined in patients.there was an avarege of 33,45 mmHg right-systolic flow, 3,48 mmHg right-diastolic flow, 34,20 mmHg left-systolic flow, 3,63 mmHg left-diastolic flow in 20 patients with preoperative 50 mg papaverine in penile doppler ultrasound.no erectile disfunction was determined.After RP patients were evaluated again for erectile functions postoperative 3. month and 6. month. Three month mean IIEF scores of patients were calculated as 6,89 (22-25). Three month penile doppler values were measured as 30,05 mmHg right cavernous systolic, 4,68 mmHg right cavernous diastolic, 31,58 mmHg left cavernous systolic, 5,06mmHg left cavernous diastolic. Six month mean IIEF scores were calculated as 7,11 (22-25) sixth month penile doppler values were measured as 35,40mmHg right cavernous systolic , 4,04 right cavernous diastolic , 34,70 mmHg left cavernous systolic , 3,89 mmHg left cavernous diastolic. Doppler U.S. findings of the third and sixth month was not statistically significant as compared to preoperative values and between them.(p<0.05)As a result of this study, no significant changes were found between postoperative 3. and 6. months systolic and diastolic pressures in patiens with falling IIEF scores.Consequently , neurogenic component is thought to be responsible for erectile dysfunction after radical retropubic prostatectomy rather than arteriyojenic etiology.For more evaluation on this topic, the studies with more number of cases are needed.