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Early patient self-assessed outcomes of nerve-sparing radical perineal prostatectomy.
Urology. 2005 Sep; 66(3):582-6.U

Abstract

OBJECTIVES

To compare the early recovery of erectile function and urinary continence in patients undergoing nerve-sparing and non-nerve-sparing radical perineal prostatectomy (RPP) using a validated patient self-assessment instrument.

METHODS

Eighty-eight patients who underwent RPP by a single surgeon between January 2002 and July 2003 were given a validated patient self-assessment questionnaire, the Expanded Prostate Cancer Index Composite, preoperatively and subsequently at 3- to 6-month intervals. Of the 88 patients, 40 underwent non-nerve-sparing and 48 nerve-sparing RPP. The time to recover erectile function and urinary continence, as well as sexual and urinary health-related quality of life was analyzed using the Kaplan-Meier method and a multivariate Cox proportional hazards model.

RESULTS

Nerve-sparing RPP was a predictor of the time to recover erections sufficient for intercourse (P = 0.013). In a multivariate regression model adjusting for baseline erectile function, age, and prostate size, preservation of the neurovascular bundle (P = 0.007) was an independent predictor of the time to recover erectile function sufficient for intercourse (hazard ratio 5.3; 95% confidence interval 1.2 to 23.1). The median time to recover urinary continence, defined as no pad use, was 4.7 months in the nerve-sparing group compared with 5.6 months in the non-nerve-sparing group (P = 0.021). In multivariate analysis, nerve-sparing status was an independent predictor (P = 0.003) of an earlier recovery of continence (hazard ratio 2.2; 95% confidence interval 1.3 to 3.6).

CONCLUSIONS

Patient self-assessed outcomes support a benefit of nerve-sparing RPP for the postoperative recovery of erectile function and urinary continence. Future studies with larger patient numbers and longer follow-up are necessary to validate these findings.

Authors+Show Affiliations

Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16140082

Citation

Wiygul, Jeremy B., et al. "Early Patient Self-assessed Outcomes of Nerve-sparing Radical Perineal Prostatectomy." Urology, vol. 66, no. 3, 2005, pp. 582-6.
Wiygul JB, Harris MJ, Dahm P. Early patient self-assessed outcomes of nerve-sparing radical perineal prostatectomy. Urology. 2005;66(3):582-6.
Wiygul, J. B., Harris, M. J., & Dahm, P. (2005). Early patient self-assessed outcomes of nerve-sparing radical perineal prostatectomy. Urology, 66(3), 582-6.
Wiygul JB, Harris MJ, Dahm P. Early Patient Self-assessed Outcomes of Nerve-sparing Radical Perineal Prostatectomy. Urology. 2005;66(3):582-6. PubMed PMID: 16140082.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early patient self-assessed outcomes of nerve-sparing radical perineal prostatectomy. AU - Wiygul,Jeremy B, AU - Harris,Michael J, AU - Dahm,Philipp, PY - 2004/10/05/received PY - 2005/03/01/revised PY - 2005/03/23/accepted PY - 2005/9/6/pubmed PY - 2005/12/13/medline PY - 2005/9/6/entrez SP - 582 EP - 6 JF - Urology JO - Urology VL - 66 IS - 3 N2 - OBJECTIVES: To compare the early recovery of erectile function and urinary continence in patients undergoing nerve-sparing and non-nerve-sparing radical perineal prostatectomy (RPP) using a validated patient self-assessment instrument. METHODS: Eighty-eight patients who underwent RPP by a single surgeon between January 2002 and July 2003 were given a validated patient self-assessment questionnaire, the Expanded Prostate Cancer Index Composite, preoperatively and subsequently at 3- to 6-month intervals. Of the 88 patients, 40 underwent non-nerve-sparing and 48 nerve-sparing RPP. The time to recover erectile function and urinary continence, as well as sexual and urinary health-related quality of life was analyzed using the Kaplan-Meier method and a multivariate Cox proportional hazards model. RESULTS: Nerve-sparing RPP was a predictor of the time to recover erections sufficient for intercourse (P = 0.013). In a multivariate regression model adjusting for baseline erectile function, age, and prostate size, preservation of the neurovascular bundle (P = 0.007) was an independent predictor of the time to recover erectile function sufficient for intercourse (hazard ratio 5.3; 95% confidence interval 1.2 to 23.1). The median time to recover urinary continence, defined as no pad use, was 4.7 months in the nerve-sparing group compared with 5.6 months in the non-nerve-sparing group (P = 0.021). In multivariate analysis, nerve-sparing status was an independent predictor (P = 0.003) of an earlier recovery of continence (hazard ratio 2.2; 95% confidence interval 1.3 to 3.6). CONCLUSIONS: Patient self-assessed outcomes support a benefit of nerve-sparing RPP for the postoperative recovery of erectile function and urinary continence. Future studies with larger patient numbers and longer follow-up are necessary to validate these findings. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/16140082/Early_patient_self_assessed_outcomes_of_nerve_sparing_radical_perineal_prostatectomy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(05)00407-3 DB - PRIME DP - Unbound Medicine ER -