Management of functional outcomes after radical prostatectomy in the Nordic countries: A survey of uro-oncological centers

Abstract

Abstract We aimed to describe the clinical practice regarding erectile dysfunction (ED) and urinary incontinence (UI) after radical prostatectomy (RP) in the Nordic countries. A 37-item survey about pre- and post-RP evaluation and rehabilitation of sexual and urinary function was sent to 42 uro-oncology centers. Twenty-seven centers in Denmark (n = 6), Norway (n = 8), Finland (n = 7), and Sweden (n = 6) responded (64.3%). Post-RP sexual function was evaluated by 25 centers. The majority used validated questionnaires with significant variations across centers. Post-RP urinary function was evaluated by 24 centers. Again, the majority used a variety of validated questionnaires, while were 9 centers used objective measures including as uroflowmetry, residual urine volume, and daily pad usage. Twenty-one centers reported to offer sexual rehabilitation and 12 of these described their protocols. All centers administered PDE5Is and seven centers offered 2nd or 3rd line options. Two centers offered a consultation with a sexologist. Twenty-three centers provided pelvic floor muscle training via a physiotherapist and one center used medical support with duloxetine. Our study indicates a need for standardized evaluation and management of ED and UI following RP. Especially, there is a need for an increased focus on sexual rehabilitation with utilization of options other than a simple PDE5I.