الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
To assess the recoverability of erectile function after different forms of radical cystoprostatectomy whether nervesparing or non nervesparing. Also the value of rehabilitation (either early or late) after radical cystoprostatectomy on recoverability of erectile function; especially after nerve sparing technique. Between Jan. 2003 and Jan. 2005, 21 NS and 24 NNS radical cystoprostatectomy were included in this study. We aimed to compare nervesparing versus non nervesparing surgeries regarding life quality subjectively (by questionnaire) and objectively (penile Doppler ultrasound) and also comparing early rehabilitation versus late rehabilitation regarding the same previous parameters. The results of this study indicated that nervesparing technique resulted in restoration of potency in a good number of cases (81%) (Spontaneous erection without aid 57.14% while PDE5I in 23.8%), without compromising of cancer control (within one year of follow up). This relatively high result may be attributed to the younger age of the patients in this study (mean age: 48.4years). There is gradual and progressive improvement in nervesparing cases with improvement of sexual quality of life (as shown from IIEF results), also this was reflected on penile Doppler results which showed insignificant deterioration of PSV (arteriogenic mechanism), but there was at first deterioration of EDV (venoocclusive mechanism) followed by gradual significant improvement in NS group. Early rehabilitation program resulted in regain of spontaneous erection in 9 out of 12 (75%) cases at first year. Nerve sparing cystectomy can ensure good outcome. Early erectile rehabilitation brings forward the natural healing time of potency and maintains non drug aided erection. Venoocclusive dysfunction plays an important role in postcystoprostatectomy erectile dysfunction. Lastly, the use of sildenafil citrate could be effective in treatment of mild to moderate erectile dysfunction in post nervesparing radical cystprostatectomy cases.