1202 Urinary Continence and Oncological Outcomes in Robotic-Assisted Radical Prostatectomy Patients According to Nerve Spare Technique

Abstract

Abstract Aim To assess the effects of nerve sparing (NS) on recovery of urinary continence, oncological outcome, and positive surgical margin (PSM) rates in patients undergoing robotic-assisted radical prostatectomy (RARP). Method Retrospective analysis of patients who underwent RARP between January-December 2017 at a single high- volume centre was undertaken. Urinary continence and symptoms according to different NS types (Non-NS, Unilateral, Bilateral) at 2, 6, 12, and 24 months were collated. COX proportional hazards model and Kaplan-Meier were used to correlate NS type with achievement of a dry-state; pad-free state; and oncological outcome defined by biochemical (PSA) recurrence (BCR), over 2 years follow-up. PSM occurrence was compared in non-nerve spared versus nerve spared prostate lobes. Results 241 patients underwent full analysis, Non-NS = 30 (12%), Unilateral = 84 (35%), Bilateral = 127 (53%). Comparing each NS cohort, there was no significant difference in the Mean (±SD) number of pads used per day, or rates-of-dryness at all time points during follow-up. Both COX-regression and Kaplan-Meier analyses found no significant association between any NS-type and biochemical recurrence or final achievement of continence. There was no significant risk association between NS-type and PSM rate, or significant difference in the rate of PSM between lobes that were nerve spared or not. Conclusions The degree of nerve sparing does not appear to enhance post-RARP continence recovery and is not associated with worse oncological outcomes, studied as positive surgical margin rates and biochemical recurrence at all time points up to 2 years of follow-up.