Erectile Dysfunction and Sexual Problems Two to Three Years After Prostatectomy Among American, Norwegian, and Spanish Patients

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Erectile dysfunction (ED) and sexual problems are important adverse effects after prostatectomy. We found a discrepancy in the reported fraction of patients from the United States (n = 494), Norway (n = 472), and Spain (n = 111) who reported ED 2 to 3 years after prostatectomy. However, after adjusting for pretreatment variables, we did not find any statistical significant differences in the association between the countries of treatment and the proportion of men with postprostatectomy ED or sexual problems.


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.


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.


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.

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