AUA 2017: Hypothermic nerve-sparing radical prostatectomy facilitates earlier recovery of potency at one-year

Boston, MA ( Regional hypothermia (RH) via endorectal cooling balloon (ECB) during radical prostatectomy (RP) is an attempt to pre-emptively mitigate the inflammatory response. Dr. Young Hwii Ko, a visiting professor to the University of California – Irvine, presents a single institution’s experience of RH, specifically within the context of sexual function recovery post-RP. The group’s robust experience included 930 nerve-sparing robot-assisted RPs (RARP) in non-high risk patients with a minimum follow-up of 12 months. The control (n=464) was adequately matched with the RH group (n=466) in all baseline demographics and clinico-pathological characteristics.

Potency was defined as an IIEF-5>17. In both the continuous and categorical analyses, patients showed a higher rate of sexual function recovery at 3 and 12 months: 17.35% RH patients returned to potency by 3 months, as compared to 9.7% in the control group (p<0.001). The difference in recovery continued to increase through 12 months, with 44.4% RH patients recovering potency, versus 29% in the control group (p=0.002). IIEF-5 scores were significantly higher at both 3M (p<0.001) and 12M (p=0.001).

Subgroup analysis was repeated on young (<65) patients, with pre-operative IIEF-5>21, yielding similar results in both the linear and logistic regression models. In multivariate analysis, RH appeared to be the sole predictor of ultimate potency recovery at 12M.

Despite promising results by a single surgeon, Dr. Thomas Ahlering (PI), states that the ECB showed no statistically significant differences in recovery of sexual function in a multi-institutional, randomized control trial of five surgeons. Further, the primary endpoint of continence showed no differences between the RH and control groups. Instead, surgeon technique in minimizing injury trumps the possible benefits of RH.

Authors: Young Hwii Ko, Douglas Skarecky, Linda Huynh, Thomas Ahlering

Presented by: Young Hwii Ko (MD/PhD) of the University of California, Irvine

Written By: Linda Huynh (BS), an assistant research specialist from the University of California, Irvine, on behalf of

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA