You have accessJournal of UrologyTechnology & Instruments: Robotics: Benign & Malignant Disease (I)1 Apr 2013859 DOES DIFFICULTY OF ROBOTIC PROSTATECTOMY CORRELATE TO POSTOPERATIVE FUNCTIONAL OUTCOMES? Shailen Sehgal, Yu-Kai Su, Yu-Chen Su, Ziho Lee, and David Lee Shailen SehgalShailen Sehgal Philadelphia, PA More articles by this author , Yu-Kai SuYu-Kai Su Philadelphia, PA More articles by this author , Yu-Chen SuYu-Chen Su Los Angeles, CA More articles by this author , Ziho LeeZiho Lee Philadelphia, PA More articles by this author , and David LeeDavid Lee Philadelphia, PA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.427AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There have been a number of studies that correlate difficulty of robotic assisted radical prostatectomy (RARP) to patient functional outcomes. However, no large series exist that examine the effect of RARP difficulty on multiple patient outcomes. We correlate RARP OR Time and estimated blood loss (EBL) with patient functional outcomes. We report which outcomes are associated with RARP difficulty in the largest series to date. METHODS We performed a retrospective cohort study of 2639 total patients from 2005 to 2011 who underwent RARP at our institution by a single surgeon under an IRB approved protocol. We correlated EBL and OR Time with patient outcomes using linear regression analyses. American Urological Association Symptoms Score (AUA SS), Sexual Health Inventory for Men (SHIM), Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-26, short form, questions #1 to #5), and weeks to 0 and 1 pad/day were analyzed at 3,6,9,12, and18 months after surgery. RESULTS At 18 months, the following outcomes were significant: Total EPIC score (sum of questions #1-5) was associated with increased OR Time by 0.51% (p=0.0013). One unit score increase in frequency of urinary leakage (EPIC #1) correlated to a 1.51% increase in OR Time (p=0.0216). Urinary Control (EPIC #2) was associated with a 3.89% increase in OR Time (p=0.0112). One score increase in pad use per day (EPIC #3) was associated with an increased OR Time by 5.35% (p=0.0002). Problem of urinary leakage (EPIC #4a) was associated with a 3.28% increase in OR Time (p=0.0005). One score increase in frequency of urination (EPIC #4e) was associated with a 2.08% increase in OR Time (p=0.0378). Overall urinary function (EPIC #5) was associated with a 1.94% increase in OR time (p=0.0299). Increased AUA symptom score was associated with increased OR Time by 0.47% (p=0.0216). At 3 months, increased pain on urination (EPIC #4b) was associated with an increased OR Time by 4.64% (p=0.0005). Interestingly, SHIM Score was not associated with OR Time or EBL. CONCLUSIONS We associate numerous continence outcomes with RARP difficulty in the largest series to date. Multiple long term continence outcomes are associated with RARP difficulty. This description can aid surgeons by lending insight into which postoperative functional outcomes are most affected by RARP difficulty and thus possibly counseling patients in a more customized manner. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e354 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shailen Sehgal Philadelphia, PA More articles by this author Yu-Kai Su Philadelphia, PA More articles by this author Yu-Chen Su Los Angeles, CA More articles by this author Ziho Lee Philadelphia, PA More articles by this author David Lee Philadelphia, PA More articles by this author Expand All Advertisement Advertisement Loading ...