Impotence Following Radical Prostatectomy: Insight Into Etiology and Prevention

Walsh, Patrick C.; Donker, Pieter J.

doi:10.1016/s0022-5347(17)53012-8

Cited by 1,324 publications

(273 citation statements)

References 20 publications

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“…Originally introduced by Terrence Millin in 1945 and then significantly refined by Patrick Walsh and colleagues in the 1980s, open radical retropubic prostatectomy (ORP) has long been considered the gold-standard treatment of clinically localized prostate cancer[5,6]. The past 2 decades have ushered in minimally invasive surgical approaches, and urologists have embraced these technological advances and refined approaches for pure laparoscopic and robotic-assisted laparoscopic radical prostatectomy (RALP) with the hope of improving patient outcomes[7,8].…”

Section: Introductionmentioning

confidence: 99%

Evidence-Based Comparison of Robotic and Open Radical Prostatectomy

Lowrance

Tarin

Shariat

2010

The Scientific World JOURNAL

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The rapid adoption of robotic-assisted laparoscopic radical prostatectomy (RALP) has occurred despite a lack of high-quality evidence demonstrating its oncologic advantages, safety, or cost effectiveness compared with open radical retropubic prostatectomy (ORP). This review examines the current literature comparing ORP and RALP, focusing on perioperative, oncologic, functional, and economic outcomes.

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Section: Introductionmentioning

confidence: 99%

Evidence-Based Comparison of Robotic and Open Radical Prostatectomy

Lowrance

Tarin

Shariat

2010

The Scientific World JOURNAL

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“…Nearly 30 years ago, Walsh and Donker [18] first described a nerve-sparing RP, which increased the acceptance of the operation to patients, referring physicians and surgeons. For many years, the open RP remained the standard for treatment of patients with a localized disease.…”

Section: Discussionmentioning

confidence: 99%

Intrafascial Dissection Significantly Increases Positive Surgical Margin and Biochemical Recurrence Rates after Robotic-Assisted Radical Prostatectomy

et al. 2012

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Introduction: Improved visualization and magnification in robot-assisted laparoscopic radical prostatectomy (RALRP) has tempted many urologists to dissect the neurovascular bundle closer to the prostate following the layers of the pseudo-capsule of the prostate. This might bear a higher risk of decreased tumor control. Materials and Methods: An analysis of a consecutive series of 186 patients who underwent RALRP at our institution was performed. The outcome of patients with intrafascial nerve-sparing (INS) was compared with the outcome of patients who underwent interfascial, extrafascial or no nerve-sparing (non-INS). Results: A total of 80 patients (43.0%) received INS. The overall R1 rate was 27.9%. For pT2 tumors the rate of R1 was 33.8% in INS versus 14.8% in non-INS (odds ratio 2.936, 95% confidence interval 1.338–6.443, p = 0.007). Recurrence-free survival was significantly shorter in INS (p = 0.05; hazard ratio 3.791). Conclusion: The intrafascial dissection technique for RALRP bears a high risk of incomplete resection in localized prostate cancer resulting in unfavorable outcome.

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“…4,11 External beam radiation therapy induced ED has an unclear cause, with the literature linking radiation dose to the bulb of the penis, the crura, and the NVB to ED, 3,12–16 with other series showing no dose effect to these structures causing ED. 17–19 The majority of these studies were done in an era before intensity modulated radiation therapy and, in series examining dose to the NVB, were limited to anatomical definitions based on a single cadaver 20 or examined dose to the NVB with brachytherapy alone.…”

Section: Introductionmentioning

confidence: 99%

Reproducibility in contouring the neurovascular bundle for prostate cancer radiation therapy

Cassidy

Nour

Liu

et al. 2018

Practical Radiation Oncology

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Purpose Efforts to define the neurovascular bundle (NVB) for prostate radiation have varied. In this series, we sought to determine the reproducibility and reliability of contouring the classical posterolateral NVB on dedicated pelvic magnetic resonance imaging (MRI) scans. Methods and materials A total of 120 NVB structures were defined on 10 3-Tesla pelvic MRI scans in patients with prostate cancer but without extraprostatic extension. One pelvic radiologist served as the expert in contouring the right and left NVB for each case. Five radiation oncologists, with varying levels of experience, contoured the right and left NVBs on these same cases. The intraclass correlation coefficient across each rater and the expert, Pearson correlation coefficient between each rater and the expert, and the Dice similarity coefficient (DSC) between each rater and the expert were calculated to evaluate contour agreement and overlap. Results The overall intraclass correlation coefficient was 0.89 (95% confidence interval [CI], 0.81-0.95). The Pearson correlation coefficient was 0.95 (95% CI, 0.86-0.98) for rater 1, 0.98 (95% CI, 0.95-0.99) for rater 2, 0.94 (95% CI, 0.86-0.98) for rater 3, 0.98 (95% CI, 0.95-0.99) for rater 4, and 0.84 (95% CI, 0.63-0.93) for rater 5. The mean DSC was 0.72 (standard deviation [SD], 0.07) for rater 1, 0.72 (SD, 0.06) for rater 2, 0.73 (SD, 0.09) for rater 3, 0.74 (SD, 0.09) for rater 4, and 0.68 (SD, 0.13) for rater 5. Overall, across all raters, the average DSC was 0.72 (SD, 0.09). Conclusions The classic posterolateral NVB can be accurately and reliably contoured on 3-Tesla pelvic MRI scans by radiation oncologists.

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Impotence Following Radical Prostatectomy: Insight Into Etiology and Prevention

Cited by 1,324 publications

References 20 publications

Evidence-Based Comparison of Robotic and Open Radical Prostatectomy

Evidence-Based Comparison of Robotic and Open Radical Prostatectomy

Intrafascial Dissection Significantly Increases Positive Surgical Margin and Biochemical Recurrence Rates after Robotic-Assisted Radical Prostatectomy

Reproducibility in contouring the neurovascular bundle for prostate cancer radiation therapy

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