Local steroid application during nerve‐sparing radical retropubic prostatectomy

• Published in: BJU international 2005-09, Vol.96 (4), p.533-535
• Main Authors: Deliveliotis, Charalambos, Delis, Athanasios, Papatsoris, Athanasios, Antoniou, Nikos, Varkarakis, Ioannis M.
• Format: Article
• Language: English
• Subjects: Betamethasone - administration & dosage; Betamethasone - therapeutic use; Biological and medical sciences; Chi-Square Distribution; Erectile Dysfunction - prevention & control; Follow-Up Studies; Glucocorticoids - administration & dosage; Glucocorticoids - therapeutic use; Humans; Male; management; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Penile Erection; Prospective Studies; prostate cancer; Prostatectomy - methods; Prostatic Neoplasms - drug therapy; Prostatic Neoplasms - surgery; radical prostatectomy; steroids; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; Tumors of the urinary system; Urinary Incontinence - prevention & control; Urinary tract. Prostate gland
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/j.1464-410X.2005.05679.x

OBJECTIVE To evaluate the effect on potency rates after surgery of applying local steroids to the neurovascular bundles (NVBs) of the prostate after bilateral nerve‐sparing radical retropubic prostatectomy (BNS‐RRP). PATIENTS AND METHODS Sixty potent men undergoing BNS‐RRP for clinically localized prostate cancer were prospectively randomized equally into two groups. In group 1, 10 mL of betamethasone cream 0.1% was applied locally to both NVBs, and group 2 had only the usual BNS‐RRP with no corticoid cream. Complications and potency were evaluated at 3, 6 and 12 months in all patients and compared between the groups. RESULTS At 12 months, 57% and 60% of patients were potent in group 1 and 2, respectively; the respective mean International Index of Erectile Function (5‐item) scores were 14.76 and 15.43 (P = 0.59). Potency rates at 3, 6 and 12 months were not significantly different between the groups, and the continence rates at 12 months were also similar, with 93% and 90% of patients in groups 1 and 2 being continent, respectively. Ten and five patients in groups 1 and 2, respectively, required a blood transfusion (P = 0.23). There were no fistulae, wound dehiscence or rectal perforations. One patient in group 2 presented 4 months after RRP with a bladder neck contracture. CONCLUSIONS Local application of betamethasone does not improve or expedite the recovery of erectile function after BNS‐RRP, but there were no complications associated with its use.