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Published in: Irish Journal of Medical Science (1971 -) 4/2017

01-11-2017 | Original Article

Patient reported functional outcomes following robotic-assisted (RARP), laparoscopic (LRP), and open radical prostatectomies (ORP)

Authors: G. J. Nason, F. O’Kelly, S. White, E. Dunne, G. P. Smyth, R. E. Power

Published in: Irish Journal of Medical Science (1971 -) | Issue 4/2017

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Abstract

Background

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.

Aim

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.

Methods

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.

Results

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.
Literature
1.
2.
go back to reference Heidenreich A, Bastian PJ, Bellmunt J et al (2014) EAU guidelines on prostate cancer. part 1: screening, diagnosis, and local treatment with curative intent-update 2013. Eur Urol 65(1):124–137CrossRefPubMed Heidenreich A, Bastian PJ, Bellmunt J et al (2014) EAU guidelines on prostate cancer. part 1: screening, diagnosis, and local treatment with curative intent-update 2013. Eur Urol 65(1):124–137CrossRefPubMed
3.
go back to reference Raina R, Pahlajani G, Agarwal A et al (2010) Long term potency after early use of a vacuum erection device following radical prostatectomy. BJU Int 106:1719–1722CrossRefPubMed Raina R, Pahlajani G, Agarwal A et al (2010) Long term potency after early use of a vacuum erection device following radical prostatectomy. BJU Int 106:1719–1722CrossRefPubMed
4.
go back to reference Defade BP, Carson CC 3rd, Kennelly MJ (2011) Postprostatectomy erectile dysfunction: the role of penile rehabilitation. Rev Urol. 13(1):6–13PubMedPubMedCentral Defade BP, Carson CC 3rd, Kennelly MJ (2011) Postprostatectomy erectile dysfunction: the role of penile rehabilitation. Rev Urol. 13(1):6–13PubMedPubMedCentral
5.
go back to reference Kim PH, Pinheiro LC, Atoria CL et al (2013) Trends in the use of incontinence procedures after radical prostatectomy: a population based analysis. J Urol 189(2):602–608CrossRefPubMed Kim PH, Pinheiro LC, Atoria CL et al (2013) Trends in the use of incontinence procedures after radical prostatectomy: a population based analysis. J Urol 189(2):602–608CrossRefPubMed
6.
go back to reference Schuessler WW, Schulam PG, Clayman RV et al (1997) Laparoscopic radical prostatectomy: initial short-term experience. Urology. 50(6):854–857CrossRefPubMed Schuessler WW, Schulam PG, Clayman RV et al (1997) Laparoscopic radical prostatectomy: initial short-term experience. Urology. 50(6):854–857CrossRefPubMed
7.
go back to reference Pasticier G, Rietbergen JB, Guillonneau B et al (2001) Robotically assisted laparoscopic radical prostatectomy: feasibility study in men. Eur Urol 40(1):70–74CrossRefPubMed Pasticier G, Rietbergen JB, Guillonneau B et al (2001) Robotically assisted laparoscopic radical prostatectomy: feasibility study in men. Eur Urol 40(1):70–74CrossRefPubMed
8.
go back to reference Akand M, Celik O, Avci E et al (2015) Open, laparoscopic and robot-assisted laparoscopic radical prostatectomy: comparative analysis of operative and pathologic outcomes for three techniques with a single surgeon’s experience. Eur Rev Med Pharmacol Sci. 19(4):525–531PubMed Akand M, Celik O, Avci E et al (2015) Open, laparoscopic and robot-assisted laparoscopic radical prostatectomy: comparative analysis of operative and pathologic outcomes for three techniques with a single surgeon’s experience. Eur Rev Med Pharmacol Sci. 19(4):525–531PubMed
9.
go back to reference Hakimi AA, Feder M, Ghavamian R (2007) Minimally invasive approaches to prostate cancer: a review of the current literature. Urol J. 4(3):130–137PubMed Hakimi AA, Feder M, Ghavamian R (2007) Minimally invasive approaches to prostate cancer: a review of the current literature. Urol J. 4(3):130–137PubMed
10.
go back to reference Yaxley JW, Coughlin GD, Chambers SK et al (2016) Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: early outcomes from a randomised controlled phase 3 study. Lancet 388(10049):1057–1066CrossRefPubMed Yaxley JW, Coughlin GD, Chambers SK et al (2016) Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: early outcomes from a randomised controlled phase 3 study. Lancet 388(10049):1057–1066CrossRefPubMed
11.
go back to reference Guillonneau B, Vallancien G (2000) Laparoscopic radical prostatectomy: the Montsouris experience. J Urol 163(2):418–422CrossRefPubMed Guillonneau B, Vallancien G (2000) Laparoscopic radical prostatectomy: the Montsouris experience. J Urol 163(2):418–422CrossRefPubMed
12.
go back to reference Ramirez D, Zargar H, Caputo P et al (2015) Robotic-assisted laparoscopic prostatectomy: An update on functional and oncologic outcomes, techniques, and advancements in technology. J Surg Oncol 112(7):746–752CrossRefPubMed Ramirez D, Zargar H, Caputo P et al (2015) Robotic-assisted laparoscopic prostatectomy: An update on functional and oncologic outcomes, techniques, and advancements in technology. J Surg Oncol 112(7):746–752CrossRefPubMed
13.
go back to reference Ahlering TE, Woo D, Eichel L et al (2004) Robot-assisted versus open radical prostatectomy: a comparison of one surgeon’s outcomes. Urology. 63(5):819–822CrossRefPubMed Ahlering TE, Woo D, Eichel L et al (2004) Robot-assisted versus open radical prostatectomy: a comparison of one surgeon’s outcomes. Urology. 63(5):819–822CrossRefPubMed
14.
go back to reference Touijer K, Kuroiwa K, Eastham JA et al (2007) Risk-adjusted analysis of positive surgical margins following laparoscopic and retropubic radical prostatectomy. Eur Urol 52:1090CrossRefPubMed Touijer K, Kuroiwa K, Eastham JA et al (2007) Risk-adjusted analysis of positive surgical margins following laparoscopic and retropubic radical prostatectomy. Eur Urol 52:1090CrossRefPubMed
15.
go back to reference Barocas DA, Salem S, Kordan Y et al (2010) Robotic assisted laparoscopic prostatectomy versus radical retropubic prostatectomy for clinically localized prostate cancer: comparison of short-term biochemical recurrence-free survival. J Urol 183:990CrossRefPubMed Barocas DA, Salem S, Kordan Y et al (2010) Robotic assisted laparoscopic prostatectomy versus radical retropubic prostatectomy for clinically localized prostate cancer: comparison of short-term biochemical recurrence-free survival. J Urol 183:990CrossRefPubMed
16.
go back to reference Haglind E, Carlsson S, Stranne J et al (2015) Urinary incontinence and erectile dysfunction after robotic versus open radical prostatectomy: a prospective, controlled, nonrandomised trial. Eur Urol. 68(2):216–225CrossRefPubMed Haglind E, Carlsson S, Stranne J et al (2015) Urinary incontinence and erectile dysfunction after robotic versus open radical prostatectomy: a prospective, controlled, nonrandomised trial. Eur Urol. 68(2):216–225CrossRefPubMed
17.
go back to reference Barry MJ, Gallagher PM, Skinner JS et al (2012) Adverse effects of robotic-assisted laparoscopic versus open retropubic radical prostatectomy among a nationwide random sample of medicare-age men. J Clin Oncol 30(5):513–518CrossRefPubMedPubMedCentral Barry MJ, Gallagher PM, Skinner JS et al (2012) Adverse effects of robotic-assisted laparoscopic versus open retropubic radical prostatectomy among a nationwide random sample of medicare-age men. J Clin Oncol 30(5):513–518CrossRefPubMedPubMedCentral
18.
go back to reference Ficarra V, Novara G, Fracalanza S et al (2009) A prospective, non-randomized trial comparing robot-assisted laparoscopic and retropubic radical prostatectomy in one European institution. BJU Int 104(4):534–539CrossRefPubMed Ficarra V, Novara G, Fracalanza S et al (2009) A prospective, non-randomized trial comparing robot-assisted laparoscopic and retropubic radical prostatectomy in one European institution. BJU Int 104(4):534–539CrossRefPubMed
19.
go back to reference O’Neil B, Koyama T, Alvarez J et al (2016) The comparative harms of open and robotic prostatectomy in population-based samples. J Urol 195(2):321–329CrossRefPubMed O’Neil B, Koyama T, Alvarez J et al (2016) The comparative harms of open and robotic prostatectomy in population-based samples. J Urol 195(2):321–329CrossRefPubMed
20.
go back to reference Lee JK, Assel M, Thong AE et al (2015) Unexpected long-term improvements in urinary and erectile function in a large cohort of men with self-reported outcomes following radical prostatectomy. Eur Urol 68(5):899–905CrossRefPubMedPubMedCentral Lee JK, Assel M, Thong AE et al (2015) Unexpected long-term improvements in urinary and erectile function in a large cohort of men with self-reported outcomes following radical prostatectomy. Eur Urol 68(5):899–905CrossRefPubMedPubMedCentral
21.
go back to reference Herrell SD, Smith JA (2005) Robotic-assisted laparoscopic prostatectomy: what is the learning curve? J Urol 66:105–107CrossRef Herrell SD, Smith JA (2005) Robotic-assisted laparoscopic prostatectomy: what is the learning curve? J Urol 66:105–107CrossRef
22.
go back to reference Thompson JE, Egger S, Bohm M et al (2014) Superior quality of life and improved surgical margins are achievable with robotic radical prostatectomy after a long learning curve: a prospective single-surgeon study of 1552 consecutive cases. Eur Urol 65:521–531CrossRefPubMed Thompson JE, Egger S, Bohm M et al (2014) Superior quality of life and improved surgical margins are achievable with robotic radical prostatectomy after a long learning curve: a prospective single-surgeon study of 1552 consecutive cases. Eur Urol 65:521–531CrossRefPubMed
Metadata
Title
Patient reported functional outcomes following robotic-assisted (RARP), laparoscopic (LRP), and open radical prostatectomies (ORP)
Authors
G. J. Nason
F. O’Kelly
S. White
E. Dunne
G. P. Smyth
R. E. Power
Publication date
01-11-2017
Publisher
Springer London
Published in
Irish Journal of Medical Science (1971 -) / Issue 4/2017
Print ISSN: 0021-1265
Electronic ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-016-1522-7

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