Laparoscopic vs open retropubic intrafascial nerve‐sparing radical prostatectomy: surgical and functional outcomes in 300 patients

Abstract

before and after surgery, and outcomes, were compared. RESULTSThe operative duration was 165 min for nsLRP and 120 min for nsRRP. Although the nsLRP group had a lower frequency of positive margins, the difference was not statistically significant. At 1 year after surgery, complete continence was reported in 97% of patients who had nsLRP and in 91% who had nsRRP ( P = 0.03). At that time, 66% of patients in the nsLRP and 51% in the nsRRP group reported being able to engage in sexual intercourse ( P < 0.05). There were no statistical differences in surgical trauma in both groups. CONCLUSIONOur study showed that nsLRP performed by expert surgeons results in better functional outcomes for continence and potency than for nsRRP. There was no significant difference between the surgical techniques in surgical trauma. KEYWORDSbilateral intrafascial nerve-sparing radical prostatectomy, surgical trauma, outcomes, continence recovery, potency Study Type -Therapy (case series) Level of Evidence 4

Prospective comparison of one year follow-up outcomes for the open complete intrafascial retropubic versus interfascial nerve-sparing radical prostatectomy

“…However, longer follow up is still needed to ascertain biochemical recurrence- free survival in this cohort. Generally, these results are comparable with the published series in literature (Montorsi et al 2005; Graefen et al 2006; Savera et al 2006; Nielsen et al 2008; Kaul et al 2006; Chuang et al 2005; Alemozaffar et al 2012; Greco et al 2010; Mattei et al 2007). …”

“…Contrary, current study shows no statistical significance regarding continence between the two groups at 3 and 12 months postoperatively. Considering complete continence as the need of 0–1 pads/day (as defined in the mentioned studies), the current continence rate post-OIF-RP will be 98% at 12 months which is higher than the reported incidence after endoscopic, open and laparoscopic intrafascial prostatectomy (93% (Stolzenburg et al 2010) and 91% vs. 96% (Greco et al 2010), respectively). Further, a continence rate after "Veil of Aphrodite nerve sparing" and "tension-free" robotic assisted radical prostatectomy of 97% (at 12 months) and 92.4% (at 4 months), respectively was reported.…”

Dorsal vein complex preserving technique for intrafascial nerve‐sparing laparoscopic radical prostatectomy

“…In our current study of unilateral nerve-sparing, which accounted for most cases (84%), continence rates of 56.8% at 1 month after DPLRP were comparable with those of 43–64% at 1 month after bilateral nerve-sparing LRP5,18–20 and 36–56% at 1 month after RALP with a variety nerve-sparing conditions 3,21,22. For early recovery from postoperative incontinence, we believe that preservation of nerves and blood vessels, such as the NVB, APA and DVC, is important.…”

Are HIV-Infected Men Vulnerable to Prostate Cancer Treatment Disparities?

“…Erectile dysfunction (ED) can be a devastating PCa treatment complication (56) that is more frequent after RP compared to radiotherapy (57, 58), with between 30–90% of patients exhibiting post-operative sexual dysfunction (59). Further, open RP may confer greater risk of ED compared to laparoscopic robotic RP (60). While we were unable to ascertain specific HIV risk factors in this sample, men who have sex with men (MSM) comprise the largest risk category in Chicago (70%)(61), similar to national trends.…”