Background: The incidence of erectile dysfunction (ED) and sexual problems after radical prostatectomy has differed greatly in reports from different centers and countries; however, few studies have taken baseline factors into account. We compared the incidence of ED and sexual problems 2 to 3 years after radical prostatectomy in American, Norwegian, and Spanish men for whom selected clinically relevant demographic and medical pretreatment variables were available.
Patients and methods: From 2003 to 2009, 1077 men (United States, n = 494; Norway, n = 472; and Spain, n = 111) scheduled for prostatectomy responded to an Expanded Prostate Cancer Index Composite questionnaire before treatment and 2 to 3 years after prostatectomy. On multivariate analysis, the odds ratios for ED and sexual problems were calculated, adjusted for the pretreatment variables found significant (P < .01) on univariate analysis.
Results: For all patients and for those without ED preoperatively, no statistically significant association was detected between the country of prostatectomy and the likelihood of reporting post-prostatectomy ED or sexual problems despite the significant differences among the 3 countries in the unadjusted analyses.
Conclusion: Adjusting for important pretreatment variables, no intercountry differences were detected. Thus, a thorough knowledge about the pretreatment medical and demographic factors is essential for valid comparisons of the incidence of postprostatectomy ED and sexual problems among different studies.
Keywords: Adverse effects; International comparison; Prostate cancer; Quality of life.
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