1955 A COMPARISON OF OUTCOMES FOR INTERFASCIAL AND INTRAFASCIAL NERVE-SPARING RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized IX1 Apr 20101955 A COMPARISON OF OUTCOMES FOR INTERFASCIAL AND INTRAFASCIAL NERVE-SPARING RADICAL PROSTATECTOMY Evangelos Liatsikos, Panagiotis Kallidonis, Minh Do, Abdulrahman Al-Aown, Anja Dietel, Robert Rabenalt, and Jens-Uwe Stolzenburg Evangelos LiatsikosEvangelos Liatsikos Patras, Greece More articles by this author , Panagiotis KallidonisPanagiotis Kallidonis Patras, Greece More articles by this author , Minh DoMinh Do Leipzig, Germany More articles by this author , Abdulrahman Al-AownAbdulrahman Al-Aown Patras, Greece More articles by this author , Anja DietelAnja Dietel Leipzig, Germany More articles by this author , Robert RabenaltRobert Rabenalt Leipzig, Germany More articles by this author , and Jens-Uwe StolzenburgJens-Uwe Stolzenburg Leipzig, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1944AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To compare the efficacy and results of the intrafascial nerve-sparing Endoscopic Extraperitoneal radical prostatectomy (nsEERPE) with the interfascial (standard) nsEERPE in an attempt to elucidate which technique provides the better outcome. METHODS 400 patients underwent nsEERPE between June 2004 and June 2008. 200 patients underwent bilateral intrafascial nsEERPE (Group A) and 200 bilateral standard nsEERPE (Group B). All patients had at least 12 months follow up. Patient demographics, mean blood loss, mean catheterisation time, complications, functional and oncological outcome were reviewed. RESULTS Patient demographics, mean blood loss and mean catheterisation time were similar between the groups. At three months, 74% of Group A and and 66.5% of Group B were continent. At 6 months the respective figures 84.2% and 82.7%. At 12 months, 93.2% of Group A and 90.8% of Group B were continent. Potency rates of Group A were 93.5% (<55 years), 83.3% (55-65 years) and 60% (>65 years) at 12 months. The respective figures for Group B were 77.1%, 63.2% and 40% at 12 months. Positive surgical margins (PSMs) were detected in 6.2% of pT2 and 31.8% of pT3 patients of Group A. PSMs in Group B were observed in 5.6% of pT2 and 26.3% of pT3 patients. CONCLUSIONS Intrafascial nsEERPE provides significantly better potency in patients 55-65 years of age at 6 and 12 months without compromising the oncological outcome. The overall potency was significantly improved in the case of intrafascial technique at 6 and 12 months. Current data supports the claim that the additional nerve preservation in the radical prostatectomy procedures may improve the functional outcomes. Table 1. Post-operative continence rates Pad usage Group A Intrafascial (Bilateral) Group B Interfascial (Bilateral) Chi square test (p values) 3months 0-1pads 74% 66.5% <0.001 2-3pads 22% 23.7% >3pads 4% 9.8% 6months 0-1pads 84.2% 82.7% 0.554 2-3pads 14.9% 13.1% >3pads 0.9% 4.2% 12months 0-1pads 93.2% 90.8% 0.271 2-3pads 6.1% 7.9% >3pads 0.7% 1.3% Table 2. Post-operative age stratified potency rates Age Group A Intrafascial (Bilateral) Group B Interfascial (Bilateral) Chi square test Fisher's exact test (p values) 6months Overall 63.8% 51.4% 0.096 0.066 <55yrs 81.3% 66.7% 0.303 0.252 55-65yrs 67.3% 44.1% 0.033 0.028 >65yrs 46.2% 36.4% 0.508 0.429 12months Overall 81.8% 64.8% 0.07 0.006 <55yrs 93.5% 77.1% 0.064 0.063 55-65yrs 83.3% 50% 0.033 0.03 >65yrs 60.0% 40% 0.24 0.2 © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e759-e760 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Evangelos Liatsikos Patras, Greece More articles by this author Panagiotis Kallidonis Patras, Greece More articles by this author Minh Do Leipzig, Germany More articles by this author Abdulrahman Al-Aown Patras, Greece More articles by this author Anja Dietel Leipzig, Germany More articles by this author Robert Rabenalt Leipzig, Germany More articles by this author Jens-Uwe Stolzenburg Leipzig, Germany More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...