Arguments against investing widely in robotic prostatectomy in Canada: a wrong focus on tool box rather than surgical expertise

Fradet, Yves

doi:10.5489/cuaj.1181

Cited by 5 publications

(2 citation statements)

References 16 publications

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“…Data on preoperative erectile function were not available. The debate on the advantages of minimally invasive prostatectomy with respect to improving outcome is ongoing, yet convincing evidence is still lacking [ 14 ] .…”

Section: Introductionmentioning

confidence: 99%

Predicting erectile function outcome in men after radical prostatectomy for prostate cancer

Kilminster¹,

Müller

Menon

et al. 2011

BJU International

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What's known on the subject? and What does the study add? Over the last decade, the surgical treatment of prostate cancer has evolved towards minimal access surgery, particularly via a robot‐assisted technique. However, there is still debate regarding the true benefit for patients with respect to a functional outcome such as erectile function. The present prediction model provides a reliable estimation of the likelihood of regaining erectile function after prostatectomy. OBJECTIVE To identify the reported rates of potency after prostatectomy in the recent literature for men without preoperative erectile dysfunction (ED) and to develop a statistical model for predicting the expected potency after prostatectomy. MATERIALS AND METHODS A Medline search was conducted with the keywords ‘potency’ and ‘prostatectomy’ from 2003 to 2009. In total, 33 studies in the English language reporting pre‐ and postoperative erectile function were identified. Data from studies reporting outcome after open, laparoscopic and robot‐assisted prostatectomy were analyzed separately. Only data obtained from potent men before surgery were included in the analysis. RESULTS In potent men before surgery, the main predictors of post‐treatment erectile function are age and time after treatment. The cumulative range of potency rates at 48 months for all ages (45–75 years) was 49–74% for open, 58–74% for laparoscopic and 60–100% for robotic prostatectomy. The predicted outcome differs by type of operation and patient age. CONCLUSIONS Men aged <60 years have a significant likelihood of regaining erectile function after radical prostatectomy. The reported statistical model provides a reliable estimation of erectile function outcome after prostatectomy for men with localized prostate cancer and intact erectile function.

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Section: Introductionmentioning

confidence: 99%

Predicting erectile function outcome in men after radical prostatectomy for prostate cancer

Kilminster¹,

Müller

Menon

et al. 2011

BJU International

View full text Add to dashboard Cite

show abstract

“…American urologists have rapidly adopted robot-assisted minimally invasive radical prostatectomy, while Canadian urologists have embraced this technology in a more limited fashion, partly because of financial constraints within the Canadian healthcare system. 13,14 It is under this light that a BSTC, although challenging, is a requirement for a more widespread and safe acceptance of robotic surgery in Canadian institutions.…”

mentioning

confidence: 99%