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Sexual function criteria post laparoscopic radical prostatectomy: a reverse systematic review

  • Urology - Review
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Abstract

Objective

To apply a new review methodology, called reverse systematic review (RSR), to assess how different classification criteria can influence erectile dysfunction rates in patients undergoing laparoscopic radical prostatectomy (LRP).

Methods

We used RSR from January 1, 2000, until December 31, 2020. The post-prostatectomy erectile dysfunction (PPED) rates were evaluated at 1, 3, 6, 12, and 18 months after surgery in different criteria selected as the most commonly used and divided into four groups: “Erection Sufficient for Intercourse (ESI)”, “IIEF-5 > 17”, “IIEF-5 > 22” and “Not Available”. Temporal distribution of different criteria was analyzed to identify patterns throughout the "natural history" of LRP.

Results

40 systematic reviews on LRP evaluated 81 cohorts and 21,618 patients on PPED. ESI was the predominant form of PPED evaluation (75.3%) followed by IIEF-5 > 22 (11.1%). Despite being a simpler criterion, ESI showed worse PPED rates at 1, 3, 6 and 12 months (8%, 27%, 43% and 51%) than IIEF-5 > 22 (14%, 26%, 45% and 58%). The studies were published between 2005 and 2015, but it was in 2010 that the ESI criterion was established as predominant in the literature, reducing the application of others.

Conclusion

The RSR has proven effective in demonstrating how the PPED evaluation criteria behaved in the “natural history” of the LRP. It showed how a simple and easy-to-apply criterion, such as the ESI, was preferred by the authors, even showing worse PPED rates than other more complex.

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Acknowledgements

To the involved institution(s), the patients, and those that provided and cared for study patients.

Funding

“National Council for Scientific and Technological Development”—CNPq, Research Productivity: 304747/2018–1 (Reis LO)”.

Author information

Author notes

  1. Tomás Bernardo Costa Moretti and Diego Moreira Capibaribe are co-first authors.

Authors and Affiliations

  1. UroScience, Department of Urology, University of Campinas (UNICAMP), and Pontifical Catholic University of Campinas (PUC-Campinas), Av. John Boyd Dunlop-Jardim Ipaussurama, Campinas, São Paulo, CEP 13034-685, Brazil

    Tomás Bernardo Costa Moretti, Diego Moreira Capibaribe, Natália Dalsenter Avilez, Wilmar Azal Neto & Leonardo Oliveira Reis

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  1. Tomás Bernardo Costa Moretti
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  2. Diego Moreira Capibaribe
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  3. Natália Dalsenter Avilez
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  4. Wilmar Azal Neto
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  5. Leonardo Oliveira Reis
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Contributions

All authors have made a substantial contribution to the information or material submitted for publication. All authors have read and approved the final manuscript. No author has direct or indirect commercial or financial incentives associated with the publishing of this manuscript. There was no extra-institutional funding for this project. The manuscript, or portions thereof, is not under consideration for publication by any other journal or electronic publication and has not been published previously.

Corresponding author

Correspondence to Leonardo Oliveira Reis.

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Moretti, T.B.C., Capibaribe, D.M., Avilez, N.D. et al. Sexual function criteria post laparoscopic radical prostatectomy: a reverse systematic review. Int Urol Nephrol 54, 2097–2104 (2022). https://doi.org/10.1007/s11255-022-03262-w

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  • DOI: https://doi.org/10.1007/s11255-022-03262-w

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