The third factor identified to have a correlation to the rate of impotence is the surgical technique, or the ability to preserve the neurovascular bundles. The primary goal during a radical prostatectomy is complete tumor excision. Therefore, depending on the size and extension of the tumor, it is not always possible to preserve both neurovascular bundles. Research has demonstrated the rate of impotence is correlated with preservation or excision of the neurovascular bundles. In summary, a review of research shows an increased rate of impotence with advancing age, increasing stage of tumor, and excision of neurovascular bundles.
Impotence can have a profound effect on the sense of well-being of patients with prostate cancer.
Because of these high percentages and potential effects on the patient, it is very important that patients be informed of the possibility of impotence after surgery. For this to occur, health care providers must be educated on the percentages of postoperative impotence and include this in their patient teaching. Treatment for impotence can be hindered because of the patient's discomfort in discussing the issue and hesitance of the health care provider to mention it. Through increased teaching about impotence patients will be informed before they undergo surgery and know what to expect after surgery. The concerns of patients with impotence and the effects of impotence after surgery are observed on a urology unit almost daily.