Abstract
ObjectiveProstate cancer is a common malignancy in men over 50 years old, and radical prostatectomy, particularly via laparoscopic and robotic-assisted techniques, significantly impacts quality of life, especially in terms of erectile dysfunction. This systematic review and meta-analysis aimed to evaluate the preservation of erectile function following robotic-assisted and laparoscopic radical prostatectomy, with a separate analysis of randomized clinical trials and non-randomized studies. MethodsThis review was carried out using randomized and non-randomized studies involving adult patients diagnosed with localized prostate cancer undergone radical prostatectomy, according to PRISMA guidelines and registered in PROSPERO. Applicable literature from PubMed, Cochrane, Embase, and the Latin American and Caribbean Health Sciences Literature (LILACS) database were analysed. The bias in randomized clinical trials was assessed using Rob 2.0, and observational studies were evaluated via the Newcastle–Ottawa Scale. The statistical analysis were performed using Review Manager 5.4. ResultsOur analysis included thirteen studies involving 6281 patients. Comparative meta-analysis of non-randomized studies demonstrated that robotic techniques were significantly more effective in preserving erectile function at 3 months (risk difference [RD] 0.05; 95% confidence interval [CI] 0.00–0.11; p=0.04), 6 months (RD 0.14; 95% CI 0.04–0.24; p=0.008), and 12 months post-procedure (RD 0.06; 95% CI 0.02–0.10; p=0.002). ConclusionRobotic-assisted surgery showed greater preservation of erectile function after prostatectomy at 3 months, 6 months, and 12 months. However, additional studies with meticulous methodological criteria are necessary for future analysis.
Published Version
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