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Preoperative criteria to select patients for bilateral nerve-sparing robotic-assisted radical prostatectomy.
J Sex Med. 2010 Feb; 7(2 Pt 1):839-45.JS

Abstract

INTRODUCTION

To date, no study has analyzed the predictors of potency recovery in a robot-assisted laparoscopic radical prostatectomy (RALP) series. A novel risk stratification for erectile function recovery after retropubic radical prostatectomy (RRP) has been proposed recently by Briganti et al. from the University Vita-Salute San Raffaele in Milan, Italy.

AIM

To evaluate the potency rate in a series of consecutive patients who underwent bilateral nerve-sparing RALP, to identify the preoperative predictors of erectile function recovery, and to validate the risk-group stratification of Briganti et al.

METHODS

The clinical records of all patients who underwent RALP for clinically localized prostate cancer between April 2005 and April 2009 were prospectively collected in the Prostate Cancer Padua Database. For the present study, we extracted all consecutive cases receiving a bilateral nerve-sparing technique with a minimum follow-up > or =12 months.

MAIN OUTCOME MEASURES

Twelve-month potency rate after RALP, defined as an International Index of Erectile Function 6 (IIEF-6) score > or =18.

RESULTS

Data showed that 129 out of 208 enrolled patients (62%) were potent 12 months after surgery. Age (hazard ratio [HR]: 2.8; P < 0.001), Charlson score (HR: 2.9; P = 0.007), and baseline IIEF-6 score (HR: 0.8; P < 0.001) were independent predictors of potency recovery at multivariate analysis. According to Briganti et al.'s risk-group stratification, the 12-month potency rate following RALP was 81.9% in the low-risk group, 56.7% in the intermediate-risk group, and 28.6% in the high-risk group (P < 0.001).

CONCLUSIONS

In the era of robotic surgery, the key point for the success of the nerve-sparing technique remains the accurate selection of patients. Age < or =65 years, absence of associated comorbidities, and good preoperative erectile function are the most important preoperative factors to select those patients for whom bilateral nerve-sparing RALP can achieve the best results.

Authors+Show Affiliations

Department of Oncologic and Surgical Sciences, Urologic Clinic, University of Padua, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19912486

Citation

Novara, Giacomo, et al. "Preoperative Criteria to Select Patients for Bilateral Nerve-sparing Robotic-assisted Radical Prostatectomy." The Journal of Sexual Medicine, vol. 7, no. 2 Pt 1, 2010, pp. 839-45.
Novara G, Ficarra V, D'Elia C, et al. Preoperative criteria to select patients for bilateral nerve-sparing robotic-assisted radical prostatectomy. J Sex Med. 2010;7(2 Pt 1):839-45.
Novara, G., Ficarra, V., D'Elia, C., Secco, S., De Gobbi, A., Cavalleri, S., & Artibani, W. (2010). Preoperative criteria to select patients for bilateral nerve-sparing robotic-assisted radical prostatectomy. The Journal of Sexual Medicine, 7(2 Pt 1), 839-45. https://doi.org/10.1111/j.1743-6109.2009.01589.x
Novara G, et al. Preoperative Criteria to Select Patients for Bilateral Nerve-sparing Robotic-assisted Radical Prostatectomy. J Sex Med. 2010;7(2 Pt 1):839-45. PubMed PMID: 19912486.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preoperative criteria to select patients for bilateral nerve-sparing robotic-assisted radical prostatectomy. AU - Novara,Giacomo, AU - Ficarra,Vincenzo, AU - D'Elia,Carolina, AU - Secco,Silvia, AU - De Gobbi,Alberto, AU - Cavalleri,Stefano, AU - Artibani,Walter, Y1 - 2009/11/12/ PY - 2009/11/17/entrez PY - 2009/11/17/pubmed PY - 2010/8/31/medline SP - 839 EP - 45 JF - The journal of sexual medicine JO - J Sex Med VL - 7 IS - 2 Pt 1 N2 - INTRODUCTION: To date, no study has analyzed the predictors of potency recovery in a robot-assisted laparoscopic radical prostatectomy (RALP) series. A novel risk stratification for erectile function recovery after retropubic radical prostatectomy (RRP) has been proposed recently by Briganti et al. from the University Vita-Salute San Raffaele in Milan, Italy. AIM: To evaluate the potency rate in a series of consecutive patients who underwent bilateral nerve-sparing RALP, to identify the preoperative predictors of erectile function recovery, and to validate the risk-group stratification of Briganti et al. METHODS: The clinical records of all patients who underwent RALP for clinically localized prostate cancer between April 2005 and April 2009 were prospectively collected in the Prostate Cancer Padua Database. For the present study, we extracted all consecutive cases receiving a bilateral nerve-sparing technique with a minimum follow-up > or =12 months. MAIN OUTCOME MEASURES: Twelve-month potency rate after RALP, defined as an International Index of Erectile Function 6 (IIEF-6) score > or =18. RESULTS: Data showed that 129 out of 208 enrolled patients (62%) were potent 12 months after surgery. Age (hazard ratio [HR]: 2.8; P < 0.001), Charlson score (HR: 2.9; P = 0.007), and baseline IIEF-6 score (HR: 0.8; P < 0.001) were independent predictors of potency recovery at multivariate analysis. According to Briganti et al.'s risk-group stratification, the 12-month potency rate following RALP was 81.9% in the low-risk group, 56.7% in the intermediate-risk group, and 28.6% in the high-risk group (P < 0.001). CONCLUSIONS: In the era of robotic surgery, the key point for the success of the nerve-sparing technique remains the accurate selection of patients. Age < or =65 years, absence of associated comorbidities, and good preoperative erectile function are the most important preoperative factors to select those patients for whom bilateral nerve-sparing RALP can achieve the best results. SN - 1743-6109 UR - https://www.unboundmedicine.com/medline/citation/19912486/Preoperative_criteria_to_select_patients_for_bilateral_nerve_sparing_robotic_assisted_radical_prostatectomy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1743-6095(15)32889-7 DB - PRIME DP - Unbound Medicine ER -