Objective To evaluate the effect on potency rates after surgery of
applying local steroids to the neurovascular bundles (NVBs) of the
prostate after bilateral nerve-sparing radical retropubic prostatectomy
(BNS-RRP).
Patients and Methods Sixty potent men undergoing BNS-RRP for clinically
localized prostate cancer were prospectively randomized equally into two
groups. In group 1, 10 mL of betamethasone cream 0.1% was applied
locally to both NVBs, and group 2 had only the usual BNS-RRP with no
corticoid cream. Complications and potency were evaluated at 3, 6 and 12
months in all patients and compared between the groups.
Results At 12 months, 57% and 60% of patients were potent in group 1
and 2, respectively; the respective mean International Index of Erectile
Function (5-item) scores were 14.76 and 15.43 (P = 0.59). Potency rates
at 3, 6 and 12 months were not significantly different between the
groups, and the continence rates at 12 months were also similar, with
93% and 90% of patients in groups 1 and 2 being continent,
respectively. Ten and five patients in groups 1 and 2, respectively,
required a blood transfusion (P = 0.23). There were no fistulae, wound
dehiscence or rectal perforations. One patient in group 2 presented 4
months after RRP with a bladder neck contracture.
Conclusions Local application of betamethasone does not improve or
expedite the recovery of erectile function after BNS-RRP, but there were
no complications associated with its use
