Name of the Condition

• Erectile Dysfunction Following Radical Prostatectomy (ICD Code N52.31)

Summary

Erectile dysfunction following radical prostatectomy refers to the inability to achieve or maintain an erection sufficient for sexual intercourse after surgical removal of the prostate gland due to prostate cancer treatment. This condition is common and distressing, but various treatment options are available.

Causes

• The primary cause is nerve damage incurred during the prostatectomy, which can impair the normal blood flow necessary for an erection.
• Radical prostatectomy involves the surgical removal of the prostate gland and sometimes surrounding tissues, which can affect the nerves and blood vessels involved in achieving and maintaining an erection.

Risk Factors

• Type of surgical technique used.
• Age of the patient, with older men more at risk.
• Preoperative erectile function—men with poorer function prior to surgery are at higher risk.
• Pre-existing cardiovascular conditions that may affect circulation.

Symptoms

• Inability to achieve or maintain an erection firm enough for sexual intercourse.
• Reduced sexual desire or interest may also be experienced, although it is less common.

Diagnosis

• Patient history and physical examination.
• Psychological evaluation to assess any mental health factors contributing to dysfunction.
• Specialized tests may include duplex ultrasound or nocturnal penile tumescence tests to assess blood flow and nocturnal erections.

Treatment Options

• Phosphodiesterase type 5 (PDE5) inhibitors such as sildenafil (Viagra) to enhance blood flow to the penis.
• Vacuum erection devices that manually stimulate blood flow.
• Penile injections or urethral suppositories.
• Surgical options like penile implants for severe cases.
• Psychotherapy or counseling to address any emotional or psychological issues.

Prognosis and Follow-Up

• Many men experience improvement over time, with nerve-sparing techniques during surgery offering better outcomes.
• Regular follow-ups with healthcare providers to monitor treatment responses and adjust therapies as needed.

Complications

• Persistent erectile dysfunction can lead to relationship issues and reduced quality of life.
• Potential side effects from treatments such as medication-related headaches or priapism (prolonged erection).

Lifestyle & Prevention

• Maintaining a healthy lifestyle with regular physical activity can improve overall vascular health, which is beneficial for erectile function.
• Smoking cessation and moderation of alcohol consumption can also help.

When to Seek Professional Help

• If erectile dysfunction persists for several months post-surgery or significantly impacts quality of life or emotional well-being.
• Any severe side effects from treatment or sudden changes in erectile function.

Additional Resources

• American Urological Association (AUA): www.auanet.org
• Us TOO International Prostate Cancer Education & Support Network: www.ustoo.org

Tips for Medical Coders

• Ensure documentation specifies Erectile Dysfunction as a direct result of radical prostatectomy.
• Distinguish from general erectile dysfunction not related to the surgical procedure.
• Verify any additional codes needed for concurrent conditions or treatments.