Erythropoietin promotes erection recovery after nerve-sparing radical retropubic prostatectomy: a retrospective analysis

J Sex Med. 2008 Oct;5(10):2392-8. doi: 10.1111/j.1743-6109.2008.00980.x. Epub 2008 Sep 5.


Introduction: Erectile dysfunction persists as a major functional complication of nerve-sparing radical prostatectomy.

Aim: To evaluate retrospectively the potential benefit of erythropoietin administration to improve erectile function recovery following radical prostatectomy.

Methods: Preoperatively potent patients who underwent nerve-sparing radical retropubic prostatectomy between March 2005 and February 2006 elected to receive erythropoietin treatment (40,000 IU subcutaneously, single injection on their preoperative day; treatment group, N = 15). A contemporaneous clinically matched cohort comprising patients who elected postoperative standard surveillance only served for comparison (control group, N = 21). Phosphodiesterase type 5 (PDE5) inhibitor "on-demand" use was applied. Potency evaluations were monitored by International Index of Erectile Function-5 questionnaires administered preoperatively and at 3, 6, and 12 months postoperatively.

Main outcome measure: Erection recovery.

Results: Health comorbidities as well as erectile function status were demonstrated to be no different between groups at baseline. Erythropoietin-treated patients demonstrated significantly higher postoperative International Index of Erectile Function-5 questionnaire scores than control group patients at 3, 6, and 12 months postoperatively with or without use of PDE5 inhibitors (P < 0.05). At 12 months postoperatively, the percentages of patients performing sexual activity were 87% and 68% of erythropoietin-treated and control patients, respectively (P = 0.213), although the erythropoietin-treated patients had a significantly greater ability to perform sexual intercourse with minimal or no difficulty (P < 0.05).

Conclusion: Erythropoietin administration on the preoperative day before undergoing nerve-sparing radical prostatectomy in men reporting normal erectile function preoperatively may confer improved erectile function recovery postoperatively.

MeSH terms

  • Adaptation, Physiological
  • Erectile Dysfunction / drug therapy*
  • Erectile Dysfunction / etiology*
  • Erythropoietin / pharmacology
  • Erythropoietin / therapeutic use*
  • Health Status Indicators
  • Humans
  • Male
  • Middle Aged
  • Penile Erection*
  • Penis / innervation*
  • Prostatectomy / adverse effects*
  • Prostatectomy / methods
  • Recombinant Proteins
  • Severity of Illness Index
  • Surveys and Questionnaires


  • Recombinant Proteins
  • Erythropoietin