Originally created 01/19/00

Men say impotency followed surgery



CHICAGO -- One of the largest surveys of men who had their cancerous prostates removed found that nearly 60 percent were impotent and more than 8 percent lacked bladder control more than a year and a half later.

While such side effects of the surgery are well-known, the figures could help patients make the difficult decision of whether to have their prostates removed.

"It's clearly a large effect on men's quality of life, and I think it's important they go into the surgery knowing that," said Janet Stanford, a researcher at Fred Hutchinson Cancer Research Center in Seattle who led the study.

The study appears today in the Journal of the American Medical Association.

Cancer of the prostate, a gland involved in semen production, is the second most common type of cancer found in American men, behind skin cancer. A total of 179,300 were diagnosed with the disease in 1999. Treatments include what is known as a radical prostatectomy -- the removal of the prostate -- and radiation.

For the study, researchers surveyed 1,291 men beginning in 1994 who had undergone a radical prostatectomy within six months of being diagnosed with prostate cancer.

The study is considered one of the most comprehensive because participants were from six states and were black, Hispanic and white. The patients ranged in age from 39 to 79.

Previous studies found a range of difficulties with incontinence and impotence a year or more after patients' prostates were removed -- 4 percent to 40 percent reported problems holding their bladders and 29 percent to 75 percent reported trouble getting and maintaining erections.

In this study, researchers found that patients who had surgery that spared one or two bundles of nerves in the area were less likely to be impotent.

About 59 percent of those who had unilateral nerve-sparing procedures (in which one of two nerve bundles can be saved) and 56 percent of those who underwent bilateral nerve sparing (both nerve bundles remain) said they were impotent 18 months or more after the surgery.