TY - JOUR
T1 - Early biochemical recurrence, urinary continence and potency outcomes following robot-assisted radical prostatectomy
AU - Berg, Kasper Drimer
AU - Thomsen, Frederik Birkebæk
AU - Hvarness, Helle
AU - Christensen, Ib Jarle
AU - Iversen, Peter
PY - 2014/8
Y1 - 2014/8
N2 - Objective. The aim of this study was to describe recovery of urinary continence and potency and report oncological and functional outcomes using the survival, continence and potency (SCP) system for patients undergoing robot-assisted radical prostatectomy (RARP). Material and methods. From 2009 to 2012, 232 patients underwent RARP. Self-reported continence, erection sufficient for intercourse (ESI) and scores on the five-item version of the International Index of Erectile Function-5 (IIEF-5) were registered by questionnaire and physician's interview preoperatively and at 3, 6 and 12 month follow-up, and subsequently on a yearly basis. Continence was defined as 0 pads, and potency as ESI or IIEF-5 greater than 17 with or without the aid of phosphodiesterase type 5 inhibitors. Oncological success was defined as absence of biochemical failure (BF) [prostate-specific antigen (PSA) ≥0.2 ng/ml]. The SCP system was used to evaluate combined oncological and functional outcomes. Results. In total, 184 patients were followed for more than 1 year. The 12 month BF-free survival rate was 97.7%. Median time to regain continence was 6.2 months; 12 months postoperatively 79.9% used 0 pads/day. Of patients with preoperative ESI, 77.6% (67.9-86.1) and 34.4% (24.1-47.5) maintained ESI 12 months postoperatively after bilateral and unilateral nerve-sparing surgery (NS), respectively. NS (p < 0.0001), increasing prostate volume (p = 0.014) and lower age (p < 0.0001) were positively associated with recovery of potency. Using the SCP system and defining potency as ESI, functional and oncological success 12 months after surgery was achieved in 69 out of 135 (51.1%) preoperative continent and potent patients who underwent unilateral or bilateral NS, and did not require adjuvant treatment; when defining potency as IIEF greater than 17, this figure was 45 out of 108 (41.7%). As expected, the proportions were significantly higher for bilateral than for unilateral NS (p ≤ 0.0014). Conclusion. RARP provides good early BF-free survival, continence and potency recovery rates for patients eligible for NS.
AB - Objective. The aim of this study was to describe recovery of urinary continence and potency and report oncological and functional outcomes using the survival, continence and potency (SCP) system for patients undergoing robot-assisted radical prostatectomy (RARP). Material and methods. From 2009 to 2012, 232 patients underwent RARP. Self-reported continence, erection sufficient for intercourse (ESI) and scores on the five-item version of the International Index of Erectile Function-5 (IIEF-5) were registered by questionnaire and physician's interview preoperatively and at 3, 6 and 12 month follow-up, and subsequently on a yearly basis. Continence was defined as 0 pads, and potency as ESI or IIEF-5 greater than 17 with or without the aid of phosphodiesterase type 5 inhibitors. Oncological success was defined as absence of biochemical failure (BF) [prostate-specific antigen (PSA) ≥0.2 ng/ml]. The SCP system was used to evaluate combined oncological and functional outcomes. Results. In total, 184 patients were followed for more than 1 year. The 12 month BF-free survival rate was 97.7%. Median time to regain continence was 6.2 months; 12 months postoperatively 79.9% used 0 pads/day. Of patients with preoperative ESI, 77.6% (67.9-86.1) and 34.4% (24.1-47.5) maintained ESI 12 months postoperatively after bilateral and unilateral nerve-sparing surgery (NS), respectively. NS (p < 0.0001), increasing prostate volume (p = 0.014) and lower age (p < 0.0001) were positively associated with recovery of potency. Using the SCP system and defining potency as ESI, functional and oncological success 12 months after surgery was achieved in 69 out of 135 (51.1%) preoperative continent and potent patients who underwent unilateral or bilateral NS, and did not require adjuvant treatment; when defining potency as IIEF greater than 17, this figure was 45 out of 108 (41.7%). As expected, the proportions were significantly higher for bilateral than for unilateral NS (p ≤ 0.0014). Conclusion. RARP provides good early BF-free survival, continence and potency recovery rates for patients eligible for NS.
KW - Adult
KW - Aged
KW - Erectile Dysfunction
KW - Follow-Up Studies
KW - Humans
KW - Incidence
KW - Male
KW - Middle Aged
KW - Neoplasm Recurrence, Local
KW - Prostatectomy
KW - Prostatic Neoplasms
KW - Questionnaires
KW - Recovery of Function
KW - Retrospective Studies
KW - Robotic Surgical Procedures
KW - Survival Rate
KW - Time Factors
KW - Treatment Outcome
KW - Urinary Incontinence
U2 - 10.3109/21681805.2014.893534
DO - 10.3109/21681805.2014.893534
M3 - Journal article
C2 - 24579803
SN - 2168-1805
VL - 48
SP - 356
EP - 366
JO - Scandinavian Journal of Urology
JF - Scandinavian Journal of Urology
IS - 4
ER -