Abstract：【Objective】To explore the high-risk factors affecting erectile dysfunction (ED) after laparoscopic radical prostatectomy. 【Methods】A retrospective analysis was performed on 160 prostate cancer patients admitted from June 2019 to June 2023, all of whom underwent laparoscopic radical prostatectomy. Patients were divided into the ED group and normal group based on postoperative ED status. Medical records were collected, and multivariate Logistic regression was used to analyze factors associated with postoperative ED. The receiver operating characteristic (ROC) curve was drawn to evaluate the efficacy of the nomogram model in predicting ED after surgery. 【Results】At 6 months postoperatively, the International Index of Erectile Function-5 (IIEF-5) score was lower than the preoperative score, with a statistically significant difference (P<0.05). Among 160 patients, 46 (28.75%) developed postoperative ED, and 114 (71.25%) had normal erectile function. The ED group had higher age, prostate-specific antigen (PSA), Gleason score, and higher proportions of smoking history, alcohol abuse history, and clinical stage T2 compared with the normal group, with statistically significant differences (P<0.05). Logistic regression analysis showed that advanced age, elevated PSA, higher Gleason score, smoking history, alcohol abuse history, and clinical stage T2 were risk factors for ED after laparoscopic radical prostatectomy (P<0.05). ROC curve analysis showed that the nomogram model had a sensitivity of 0.870 (95%CI: 0.613-0.972), specificity of 0.772 (95%CI: 0.563-0.871), and area under the curve (AUC) of 0.893 (95%CI:0.851-0.935) for predicting postoperative ED. 【Conclusion】Advanced age, elevated PSA, higher Gleason score, smoking history, alcohol abuse history, and rapid pathological progression are high-risk factors for ED after laparoscopic radical prostatectomy. Clinicians should provide relevant interventions in a timely manner based on specific patient conditions.
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2025, Vol. 42 
