MP46-05 IMPACT OF MINIMALLY INVASIVE APPROACH ON THE PROBABILITY OF EARLY COMPLETE FUNCTIONAL RECOVERY AFTER BILATERAL NERVE SPARING RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized IV1 Apr 2014MP46-05 IMPACT OF MINIMALLY INVASIVE APPROACH ON THE PROBABILITY OF EARLY COMPLETE FUNCTIONAL RECOVERY AFTER BILATERAL NERVE SPARING RADICAL PROSTATECTOMY Luca Villa, Nazareno Suardi, Andrea Gallina, Andrea Russo, Giovanni Lughezzani, Niccolò Buffi, Alessandro Larcher, Rocco Damiano, Francesco Cantiello, Massimo Lazzeri, Shahrokh F. Shariat, Giorgio Guazzoni, Francesco Montorsi, and Alberto Briganti Luca VillaLuca Villa More articles by this author , Nazareno SuardiNazareno Suardi More articles by this author , Andrea GallinaAndrea Gallina More articles by this author , Andrea RussoAndrea Russo More articles by this author , Giovanni LughezzaniGiovanni Lughezzani More articles by this author , Niccolò BuffiNiccolò Buffi More articles by this author , Alessandro LarcherAlessandro Larcher More articles by this author , Rocco DamianoRocco Damiano More articles by this author , Francesco CantielloFrancesco Cantiello More articles by this author , Massimo LazzeriMassimo Lazzeri More articles by this author , Shahrokh F. ShariatShahrokh F. Shariat More articles by this author , Giorgio GuazzoniGiorgio Guazzoni More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Alberto BrigantiAlberto Briganti More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1438AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives To date, no study tested the benefit of RARP in terms of early post-operative full functional recovery. We tested whether surgical approach affects both early post-operative urinary continence (UC) and erectile function (EF) recovery. Methods We identified 1798 patients affected by prostate cancer treated with bilateral nerve-sparing radical prostatectomy between June 1993 and February 2013 at a single tertiary care center. EF recovery was defined as a post-operative International Index of Erectile Function (IIEF-EF) >21. UC recovery was defined as an International Consultation on Incontinence questionnaire (ICIQ) score ≤6. The role of surgical technique on UC, EF, and Bifecta recovery at 2 months after surgery was evaluated at univariable (UVA) and multivariable (MVA) logistic regression analyses. Finally, UVA and MVA Cox regression analyses assessed the role of surgical approach on functional outcomes over time. Covariates consisted of age at surgery, BMI, pre-operative EF, PSA, pathological stage and grade. Results At a mean follow-up of 41.8 months (median: 36 months), 75.1 and 54.9 % of patients recovered UC and EF, and 616 patients recovered both conditions (42.5%). At 2 months after surgery, 36.5, 13.2 and 7.6% of patients recovered UC, EF and both conditions, respectively. UC, EF and Bifecta recovery at 2 months after surgery in men treated with RARP were significantly higher than patients treated with RRP (all p<0.001). At MVA analyses predicting UC recovery at 2 months, age, pre-operative EF and surgical technique emerged as the only predictors (OR=0.96, OR=1.66, and OR= 4.13, all respectively; p≤0.03). The same variables were also the only predictors of EF recovery at 2 months after surgery (OR=0.95, OR=3.01, and OR=3.23, respectively; all p≤0.008). Similar results were observed when Bifecta at 2 months was considered as endpoint (OR=0.95, OR=7.3, and OR=5.7, respectively; all p≤0.007). At Cox regression analyses, surgical approach remained also a major independent predictor of optimal functional outcomes over time (HR=2.3, 1.6 and 1.9 when predicting UC, EF and Bifecta recovery, respectively, all p<0.01). Conclusions Robotic-assisted surgery provides better early functional outcomes than RRP. Patients treated with RARP had roughly 4-fold, 3-fold and 6-fold higher probability of UC, EF, and Bifecta recovery at 2 months after surgery than patients treated with RRP, respectively. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e511-e512 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Luca Villa More articles by this author Nazareno Suardi More articles by this author Andrea Gallina More articles by this author Andrea Russo More articles by this author Giovanni Lughezzani More articles by this author Niccolò Buffi More articles by this author Alessandro Larcher More articles by this author Rocco Damiano More articles by this author Francesco Cantiello More articles by this author Massimo Lazzeri More articles by this author Shahrokh F. Shariat More articles by this author Giorgio Guazzoni More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...