Daijiworld Media Network - New Delhi

New Delhi, Nov 26: A new study has found that men with prostate cancer and pre-existing erectile dysfunction (ED) may benefit significantly when an inflatable penile prosthesis (PP) is implanted at the same time as robot-assisted radical prostatectomy (RARP). The research suggests that this combined procedure can speed up sexual recovery without affecting cancer outcomes or surgical safety.

The study followed 56 men treated between 2011 and 2023, all of whom had severe or refractory ED before their prostate cancer diagnosis. Of them, 29 underwent PP placement during their RARP, while 27 received the implant later, on an average 3.3 years after cancer surgery. All procedures were carried out by the same surgeon to maintain uniformity in results.

Despite the simultaneous group having a higher number of patients with severe ED (55.2% compared to 25.9%), these men reported better postoperative sexual outcomes. One year after surgery, they recorded higher satisfaction levels on the Modified Erectile Dysfunction Inventory of Treatment Satisfaction (79.1 vs 61.1) and also performed better on the EORTC Sexual Health assessment (62.5 vs 47.1). Both differences were found to be statistically significant.

The combined procedure also helped preserve penile length—an important concern for prostate cancer patients. Men who received the prosthesis during RARP experienced almost no length loss (0.32 cm), while those who opted for delayed implantation lost more than a centimetre (1.43 cm). Researchers attribute this to avoiding long periods of post-surgical tissue shrinkage.

Importantly, cancer-related outcomes remained unaffected. Rates of positive surgical margins (13.7% vs 18.5%) and biochemical recurrence at two years (10.3% vs 14.8%) were comparable in both groups, with no major complications reported. The findings confirm that adding a penile prosthesis during RARP does not hinder cancer removal or follow-up monitoring.

The authors noted that integrating both procedures offers a streamlined path for patients facing prostate cancer and severe ED, providing quicker rehabilitation and an earlier return to sexual function—an improvement that could significantly enhance long-term quality of life.