The technique and effectiveness of potency preservation in robotic-assisted laparoscopic radical prostatectomy

Abstract

Objective To evaluate the key technique and effectiveness of potency preservation in robotic-assisted laparoscopic radical prostatectomy (RALP). Methods The complete clinical and follow-up data of 30 cases underwent RALP between February and May of 2016 were reviewed retrospectively. The average age of the patients was 67.3 years (48-82 years). The peak PSA level before surgery ranged from 7.6 to 53.4 ng/ml with the average level of 21.1 ng/ml. There were 7, 16, 6 and 1 case with the Gleason score of 6, 7, 8, and 9 point, respectively. Preoperative erectile score (IIEF-5) of the 30 patients were list as below: 3 cases (0-10 points), 4 cases(11-15 points), 17 cases(16-20 points), and 6 cases(21-25 points). The key techniques of potency preservation during RALRP includes deep dorsal vein ligation techniques, neurovascular bundles preservation techniques and drain tube placement techniques. Results All 30 cases underwent operation successfully with no transfer to open surgery. Average operative time was 150.7 min (98-240 min) with an estimated blood loss of 165.7ml (50-550 ml). The average drainage removal time was 5.1 d postoperatively. The average bowel recovery time was 2.7 d and average hospitalization time was 8.2 d, respectively. There were two cases with one positive margin on the bladder neck and one on the tip of prostate, respectively. Seventeen cases gained potency preservation six months after surgery. Conclusion It was safe and beneficial for the potency preservation in RALP, which could be considered as one of the best options for the prostate cancer surgery. Key words: Prostatic neoplasms; Robotic-assisted surgery; Potency preservation