Early biochemical recurrence, urinary continence and potency outcomes following robot-assisted radical prostatectomy

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 -