 |
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2026, vol. 32, issue2
Subject Area: Medicine
-
DOI: 10.5272/jimab.2026322.6937
Published online: 24 June 2026
Original article
J of IMAB. 2026 Apr-Jun;32(2):6937-6942
COMPARISON OF POSTOPERATIVE ERECTILE DYSFUNCTION AFTER ROBOTIC AND LAPAROSCOPIC RADICAL PROSTATECTOMY
Angel Atanasov1
, Vladislav Dunev1, Martin Stoykov2, Boyan Atanasov1
,
1) Department of Urology, UMHAT "Saint Marina", Medical University - Pleven, Bulgaria.
2) Department of Surgery, UMHAT "Saint Marina", Medical University - Pleven, Bulgaria.
ABSTRACT:
Introduction: Prostate carcinoma is one of the most frequently diagnosed malignancies and represents a major medico-social problem worldwide. With the advancement of minimally invasive surgical techniques, increasing emphasis has been placed on postoperative functional outcomes and quality of life.
Purpose: To compare erectile dysfunction, orgasmic function, sexual desire, satisfaction with sexual intercourse, and overall satisfaction in the late postoperative period following laparoscopic versus robot-assisted radical prostatectomy.
Material and Methods: From January 2024 to January 2025, 77 patients with organ-confined prostate cancer underwent radical prostatectomy at University Hospital "St. Marina," Medical University of Pleven. Patients were allocated into two groups according to surgical approach: laparoscopic radical prostatectomy (LRP, n = 40) and robot-assisted radical prostatectomy (RARP, n = 37). Functional outcomes were evaluated at 3, 6, and 12 months postoperatively using validated questionnaires, including the International Index of Erectile Function (IIEF) and quality-of-life assessment tools. Descriptive and comparative statistical analyses were performed.
Results: Erectile function improved progressively in both groups after the third postoperative month, with significantly higher scores observed in patients undergoing RARP. Orgasmic function showed a trend toward better recovery in the RARP group, although no statistically significant difference was found. Sexual desire and satisfaction with sexual intercourse improved in both groups, without significant intergroup differences. Overall satisfaction increased over time and was significantly higher in the RARP group.
Conclusion: Robot-assisted radical prostatectomy is associated with superior erectile function recovery and higher overall postoperative satisfaction compared with laparoscopic radical prostatectomy, supporting its role in improving functional outcomes and quality of life.
Keywords: prostate cancer; radical prostatectomy; robotic surgery; laparoscopic surgery; erectile dysfunction,
- Download FULL TEXT /PDF 1425 KB/
Please cite this article as: Atanasov A, Dunev V, Stoykov M, Atanasov B. Comparison of postoperative erectile dysfunction after robotic and laparoscopic radical prostatectomy. J of IMAB. 2026 Apr-Jun;32(2):6937-6942. [Crossref - 10.5272/jimab.2026322.6937]
Correspondence to: Boyan Atanasov, Department of Urology, Faculty of Medicine, Medical University – Pleven; 1, Hristo Botev Blvd., 5500 Lovech, Bulgaria. E-mail: atanasovmd@yahoo.com
REFERENCES:
1. Bergengren O, Pekala KR, Matsoukas K, Fainberg J, Mungovan SF, Bratt O, et al. 2022 Update on Prostate Cancer Epidemiology and Risk Factors-A Systematic Review. Eur Urol. 2023 Aug;84(2):191-206. [PubMed ]
2. Capogrosso P, Salonia A, Briganti A, Montorsi F. Postprostatec+tomy Erectile Dysfunction: A Review. World J Mens Health. 2016 Aug;34(2):73-88. [PubMed]
3. Kesch C, Heidegger I, Kasivisvanathan V, Kretschmer A, Marra G, Preisser F, et al. Radical Prostatectomy: Sequelae in the Course of Time. Front Surg. 2021 May 28;8:684088. [PubMed]
4. Castiglione F, Ralph DJ, Muneer A. Surgical Techniques for Managing Post-prostatectomy Erectile Dysfunction. Curr Urol Rep. 2017 Sep 30;18(11):90. [PubMed]
5.Capogrosso P, Ventimiglia E, Cazzaniga W, Montorsi F, Salonia A. Orgasmic dysfunction after radical prostatectomy. World J Mens Health. 2017 Apr;35(1):1-13. [Crossref]
6. Salonia A, Castagna G, Capogrosso P, Castiglione F, Briganti A, Montorsi F. Prevention and management of post-prostatectomy erectile dysfunction. Transl Androl Urol. 2015 Aug;4(4):421-37. [PubMed]
7. Haglind E, Carlsson S, Stranne J, Wallerstedt A, Wilderäng U, Thorsteinsdottir T, et al. Urinary Incontinence and Erectile Dysfunction After Robotic Versus Open Radical Prostatectomy: A Prospective, Controlled, Nonrandomised Trial. Eur Urol. 2015 Aug;68(2):216–225. [Crossref]
8. Kadıoğlu A, Ortaç M, Brock G. Pharmacologic and surgical therapies for sexual dysfunction in male cancer survivors. Transl Androl Urol. 2015 Apr;4(2):148–59. [PubMed]
9. Fan S, Chen Z, Zhou F, Lv Q, Wang D, Ren S, Tian X. Comparison of perioperative and functional outcomes of single-incision versus standard multi-incision robot-assisted laparoscopic radical prostatectomy: a prospective, controlled, non-randomized trial. J Surg Endosc. 2024 May 3;18(1):195. [PubMed]
Received: 21 December 2025
Published online: 24 June 2026