To compare preoperative, intraoperative, and postoperative variables at 1, 6, and 12 months after laparoscopic simple prostatectomy (LSP), robotic simple prostatectomy (RSP), and intra-fascial robotic simple prostatectomy (IF-RSP).
From January 2003 to November 2014, 315 simple prostatectomies were performed using three techniques, LSP, RSP, and IF-RSP; of the patients who underwent these procedures, 236 met the inclusion criteria for this study.
No statistically significant difference (SSD) was found in preoperative or perioperative variables. Of the postoperative variables that were analyzed, a SSD (p>0. 01) in prostate-specific antigen (PSA) levels was found, with levels of 0. 07 ng/ml (±1. 1 ng/ml) following IF-RSP, and the detection rate of prostate adenocarcinoma (PC; 26%) and high-grade intraepithelial neoplasia (HG-PIN; 12%) were higher for IF-RSP. We also found that lower International Prostate Symptom Scores (IPSS) were associated with LSP, at 4. 8 (±3. 2). Erectile function was reduced in IF-RSP patients in the first six months after surgery but was similar in all patient groups at 12 months after surgery; continence and other measured parameters were also similar at 12 months for all three techniques.
The IF-RSP technique is safe and effective, with results at one-year follow-up for continence, IPSS, and SHIM scores similar to those for the LSP and RSP techniques. IF-RSP also offers the advantages that it does not require postoperative irrigation, has an increased ability to detect ADC and PIN-HG, Avoids the risk of future cancer and subsequent re-intervention for possible new prostate growth.
Journal of endourology / Endourological Society. 2015 Oct 14 [Epub ahead of print]
Oscar Martin, Raed A Azhar, Leonardo Brunacci, Nelson E Ramirez-Troche, Luis G Medina, Luis C Hernandez, Luciano Nunez Bragayrac, Rene J Sotelo
Instituto Médico La Floresta, Urology, Caracas, Venezuela, Bolivarian Republic of. , USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, Urology, Los Angeles, California, United States ; Instituto Médico La Floresta, Urología Caracas, Venezuela, Urology, Caracas, Venezuela, Bolivarian Republic of ; Instituto Médico La Floresta, Urología Caracas, Venezuela, Urology, Caracas, Venezuela, Bolivarian Republic of ; Instituto Médico La Floresta, Urología Caracas, Venezuela, Urology, Caracas, Venezuela, Bolivarian Republic of ; Instituto Médico La Floresta, Urología Caracas, Venezuela, Urology, Caracas, Venezuela, Bolivarian Republic of ; Instituto Médico La Floresta, Urología Caracas, Venezuela, Urology, Caracas, Venezuela, Bolivarian Republic of. , Instituto Médico La Floresta, Urología Caracas, Venezuela, Urology, Caracas, Venezuela, Bolivarian Republic of.