Long-Term Follow-Up After Laparoscopic Radical Prostatectomy for Localized and Locally Advanced Prostate Cancer

Abstract

Objective To explore the impact of laparoscopic radical prostatectomy (LRP) on lower urinary tract symptoms and erectile function. Materials and Methods A retrospective study was conducted on patients who underwent LRP at the Civil Hospital Ahmedabad’s Urology Department from June 2008 to June 2023. Results Major complications following LRP are generally rare, including bladder neck stenosis, erectile dysfunction, and urinary incontinence. The incidence of erectile dysfunction varies widely, ranging from 11-87%, and urinary incontinence ranges from 0-87%, depending on the definitions used. Functional decline typically peaks shortly after surgery, with the most rapid recovery occurring within the first year post-LRP. Some patients continue to improve gradually over time. However, for some men, these adverse effects can be long-lasting. Other, less common side effects should also be considered. Despite significant technological advancements in the past 20 years, no single surgical technique has emerged as superior in terms of long-term outcomes, as surgical volume, surgeon experience, and patient characteristics remain key determinants. Conclusion When discussing treatment options for prostate cancer, it is crucial to consider potential complications like erectile dysfunction and urinary incontinence following LRP, as well as the expected recovery period. Counseling is provided to patients, taking into account their age and overall health profile. Surgical advice is given to eligible patients after evaluating the risk-benefit ratio. Patients who are older or do not meet the criteria are given appropriate guidance. All patients are informed about the possible complications after surgery and are presented with the option of palliative care or surgical treatment.