Radical prostatectomy for prostate cancer is associated with significant complications, such as urinary incontinence and erectile dysfunction. Debate remains regarding the influence of surgical technique on these important functional outcomes.
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The aim of this study was to compare the early functional outcomes following robotic-assisted (RARP), laparoscopic (LRP), and open radical prostatectomy (ORP) in a rapid access cohort.
A retrospective review of a prospectively maintained database was performed between 2011 and 2014. Functional status was objectively assessed using the International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF-5), and a self-reported continence score.
Two hundred and ninety-two patients underwent RP (85 RARP, 100 LRP, 107 ORP). The mean age was 61.3 years with a mean initial PSA was 6.2 ng/ml. There was no difference noted in urinary function between ORP, LRP, and RARP at 3 months (p = 0.894), 6 months (p = 0.244), 9 months (p = 0.068) or 12 months (p = 0.154). All men noted a deterioration in erectile function; however, there was no difference at 3 months (p = 0.922), 6 months (p = 0.723), 9 months (p = 0.101) or 12 months (p = 0.395), CONCLUSION: Equivalent good early functional outcomes are being achieved in patients undergoing RP irrespective of surgical approach. Longer follow-up in a prospective randomized fashion is required to fully assess the most appropriate surgical technique.
Irish journal of medical science. 2016 Oct 28 [Epub ahead of print]
G J Nason, F O'Kelly, S White, E Dunne, G P Smyth, R E Power
Department of Urology, Beaumont Hospital, Dublin 9, Ireland. ., Department of Urology, Beaumont Hospital, Dublin 9, Ireland.