Versorgung der erektilen dysfunktion nach radikaler prostatektomie in Deutschland: Einschätzung durch den urologen versus patientenbefragung

Introduction. The aim of this national study was to evaluate ED management after RPX (without adjuvant/palliative therapy) from the patient's view compared to the urologist's view. Material and methods. In May 2003 we queried 1063 urologists and 801 patients following radical prostatectomy without adjuvant therapy. They were asked about preserved potency without erectile aid, existing wish for ED therapy, recommended or tested erectile aid (oral, transurethral, intracorporal, vacuum constriction device [VCD], penile implant) as well as the long-term use. Return rate: patients 80.1%, urologists 26.7%. Results. According to the urologist's view 9.1% of patients were potent without a device, but according to the polled patients only 4.7%. The wish to be treated for erectile dysfunktion existed in the urologist's opinion in 46,1% of their patients, while they considered that 44,8% had no wish for treatment. On the other hand 59,3% of the patients would like to be treated and only 28,5% did not want any kind of treatment. Regarding the long-term use of therapy for ED, the urologists thought that 26,1% of their patients did not receive therapy for the problem, and 69,7% of the patients stated they received no long-term therapy. Only 30,3% of the patients confirmed long-term therapy, while the urologists thought that 73,9 % of the patients useed erectile aid. Definite therapy in the urologists' opinion involved: oral medication in 38,4%, MUSE® in 3,6%, SKAT in 37,3%, VCD in 20,4% and a prothesis in 0,3%. Indeed 19.8% of the patients used oral medication, 1.7% MUSE®, 26.7%,SKAT, 50.9%, VCD, and 0.9% penile implant. Considering the satisfaction of patients, urologists thought that 46,2% of the patients were satisfied with their treatment of ED, but only 28,9% of the patients were actually satisfied themselves. Conclusions. The comparison shows a clearly different description of the ED-situation after RPX. The proportion of patients with a wish for treatment and the proportion of dissatisfied patients are much higher from the patients' view. This demonstrates an undertreatment of ED patients after RPX, which should also be taken into account under the current changes in the German health care system.