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Impact of nerve sparing technique on patient self-assessed outcomes after radical perineal prostatectomy.
J Urol. 2007 Aug; 178(2):488-92; discussion 492.JU

Abstract

PURPOSE

We investigated the impact of nerve sparing technique on erectile function, urinary continence and health related quality of life after radical perineal prostatectomy using a validated self-assessment questionnaire.

MATERIALS AND METHODS

The Expanded Prostate Cancer Index Composite questionnaire was administered preoperatively and at defined intervals after surgery to 265 patients who underwent radical perineal prostatectomy at 2 institutions between January 2001 and December 2004. Of these patients 153 (57.7%) and 112 (42.3%) underwent nonnerve sparing and nerve sparing approaches, respectively. Kaplan-Meier analysis was used to determine time to recovery of erectile function (erections firm enough for intercourse) and urinary continence (0 pads per day).

RESULTS

Median patient age was 60.6 years. Median followup was 15 months. In multivariate analysis preoperative erectile function (p = 0.005) and preservation of the neurovascular bundle (p = 0.018) were independent predictors of earlier recovery of erectile function, with hazard ratios of 2.3 (95% CI 1.2-4.6) and 4.0 (95% CI 1.5-10.3), respectively. Median time to recovery of urinary continence was 4.8 months in the nerve sparing group and 6.1 months in the nonnerve sparing group (p = 0.001). In multivariate analysis nerve sparing technique (p = 0.001, HR 1.4, 95% CI 1.1-1.9) and age (p = 0.012, HR 1.7, 95% CI 1.3-2.2) were independent predictors of recovery of continence.

CONCLUSIONS

This analysis suggests that nerve sparing radical perineal prostatectomy is associated with improved recovery of urinary continence and favorable health related quality of life scores and, therefore, should be considered a viable alternative to other nerve sparing approaches.

Authors+Show Affiliations

Department of Urology, University of Florida, Gainesville, Florida 32610-0247, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17561133

Citation

Kübler, Hubert R., et al. "Impact of Nerve Sparing Technique On Patient Self-assessed Outcomes After Radical Perineal Prostatectomy." The Journal of Urology, vol. 178, no. 2, 2007, pp. 488-92; discussion 492.
Kübler HR, Tseng TY, Sun L, et al. Impact of nerve sparing technique on patient self-assessed outcomes after radical perineal prostatectomy. J Urol. 2007;178(2):488-92; discussion 492.
Kübler, H. R., Tseng, T. Y., Sun, L., Vieweg, J., Harris, M. J., & Dahm, P. (2007). Impact of nerve sparing technique on patient self-assessed outcomes after radical perineal prostatectomy. The Journal of Urology, 178(2), 488-92; discussion 492.
Kübler HR, et al. Impact of Nerve Sparing Technique On Patient Self-assessed Outcomes After Radical Perineal Prostatectomy. J Urol. 2007;178(2):488-92; discussion 492. PubMed PMID: 17561133.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of nerve sparing technique on patient self-assessed outcomes after radical perineal prostatectomy. AU - Kübler,Hubert R, AU - Tseng,Timothy Y, AU - Sun,Leon, AU - Vieweg,Johannes, AU - Harris,Michael J, AU - Dahm,Philipp, Y1 - 2007/06/11/ PY - 2006/11/08/received PY - 2007/6/15/pubmed PY - 2007/8/23/medline PY - 2007/6/15/entrez SP - 488-92; discussion 492 JF - The Journal of urology JO - J Urol VL - 178 IS - 2 N2 - PURPOSE: We investigated the impact of nerve sparing technique on erectile function, urinary continence and health related quality of life after radical perineal prostatectomy using a validated self-assessment questionnaire. MATERIALS AND METHODS: The Expanded Prostate Cancer Index Composite questionnaire was administered preoperatively and at defined intervals after surgery to 265 patients who underwent radical perineal prostatectomy at 2 institutions between January 2001 and December 2004. Of these patients 153 (57.7%) and 112 (42.3%) underwent nonnerve sparing and nerve sparing approaches, respectively. Kaplan-Meier analysis was used to determine time to recovery of erectile function (erections firm enough for intercourse) and urinary continence (0 pads per day). RESULTS: Median patient age was 60.6 years. Median followup was 15 months. In multivariate analysis preoperative erectile function (p = 0.005) and preservation of the neurovascular bundle (p = 0.018) were independent predictors of earlier recovery of erectile function, with hazard ratios of 2.3 (95% CI 1.2-4.6) and 4.0 (95% CI 1.5-10.3), respectively. Median time to recovery of urinary continence was 4.8 months in the nerve sparing group and 6.1 months in the nonnerve sparing group (p = 0.001). In multivariate analysis nerve sparing technique (p = 0.001, HR 1.4, 95% CI 1.1-1.9) and age (p = 0.012, HR 1.7, 95% CI 1.3-2.2) were independent predictors of recovery of continence. CONCLUSIONS: This analysis suggests that nerve sparing radical perineal prostatectomy is associated with improved recovery of urinary continence and favorable health related quality of life scores and, therefore, should be considered a viable alternative to other nerve sparing approaches. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/17561133/Impact_of_nerve_sparing_technique_on_patient_self_assessed_outcomes_after_radical_perineal_prostatectomy_ L2 - https://www.jurology.com/doi/10.1016/j.juro.2007.03.100?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -