Tags

Type your tag names separated by a space and hit enter

Early biochemical recurrence, urinary continence and potency outcomes following robot-assisted radical prostatectomy.
Scand J Urol. 2014 Aug; 48(4):356-66.SJ

Abstract

OBJECTIVE

The aim of this study was to describe recovery of urinary continence and potency and report oncological and functional outcomes using the survival, continence and potency (SCP) system for patients undergoing robot-assisted radical prostatectomy (RARP).

MATERIAL AND METHODS

From 2009 to 2012, 232 patients underwent RARP. Self-reported continence, erection sufficient for intercourse (ESI) and scores on the five-item version of the International Index of Erectile Function-5 (IIEF-5) were registered by questionnaire and physician's interview preoperatively and at 3, 6 and 12 month follow-up, and subsequently on a yearly basis. Continence was defined as 0 pads, and potency as ESI or IIEF-5 greater than 17 with or without the aid of phosphodiesterase type 5 inhibitors. Oncological success was defined as absence of biochemical failure (BF) [prostate-specific antigen (PSA) ≥ 0.2 ng/ml]. The SCP system was used to evaluate combined oncological and functional outcomes.

RESULTS

In total, 184 patients were followed for more than 1 year. The 12 month BF-free survival rate was 97.7%. Median time to regain continence was 6.2 months; 12 months postoperatively 79.9% used 0 pads/day. Of patients with preoperative ESI, 77.6% (67.9-86.1) and 34.4% (24.1-47.5) maintained ESI 12 months postoperatively after bilateral and unilateral nerve-sparing surgery (NS), respectively. NS (p < 0.0001), increasing prostate volume (p = 0.014) and lower age (p < 0.0001) were positively associated with recovery of potency. Using the SCP system and defining potency as ESI, functional and oncological success 12 months after surgery was achieved in 69 out of 135 (51.1%) preoperative continent and potent patients who underwent unilateral or bilateral NS, and did not require adjuvant treatment; when defining potency as IIEF greater than 17, this figure was 45 out of 108 (41.7%). As expected, the proportions were significantly higher for bilateral than for unilateral NS (p ≤ 0.0014).

CONCLUSION

RARP provides good early BF-free survival, continence and potency recovery rates for patients eligible for NS.

Authors+Show Affiliations

Copenhagen Prostate Cancer Center, Department of Urology, Rigshospitalet, University of Copenhagen , Denmark.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24579803

Citation

Berg, Kasper Drimer, et al. "Early Biochemical Recurrence, Urinary Continence and Potency Outcomes Following Robot-assisted Radical Prostatectomy." Scandinavian Journal of Urology, vol. 48, no. 4, 2014, pp. 356-66.
Berg KD, Thomsen FB, Hvarness H, et al. Early biochemical recurrence, urinary continence and potency outcomes following robot-assisted radical prostatectomy. Scand J Urol. 2014;48(4):356-66.
Berg, K. D., Thomsen, F. B., Hvarness, H., Christensen, I. J., & Iversen, P. (2014). Early biochemical recurrence, urinary continence and potency outcomes following robot-assisted radical prostatectomy. Scandinavian Journal of Urology, 48(4), 356-66. https://doi.org/10.3109/21681805.2014.893534
Berg KD, et al. Early Biochemical Recurrence, Urinary Continence and Potency Outcomes Following Robot-assisted Radical Prostatectomy. Scand J Urol. 2014;48(4):356-66. PubMed PMID: 24579803.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early biochemical recurrence, urinary continence and potency outcomes following robot-assisted radical prostatectomy. AU - Berg,Kasper Drimer, AU - Thomsen,Frederik Birkebæk, AU - Hvarness,Helle, AU - Christensen,Ib Jarle, AU - Iversen,Peter, Y1 - 2014/03/03/ PY - 2014/3/4/entrez PY - 2014/3/4/pubmed PY - 2015/3/31/medline KW - SCP outcome KW - biochemical recurrence KW - erectile function KW - robot-assisted radical prostatectomy KW - urinary continence SP - 356 EP - 66 JF - Scandinavian journal of urology JO - Scand J Urol VL - 48 IS - 4 N2 - OBJECTIVE: The aim of this study was to describe recovery of urinary continence and potency and report oncological and functional outcomes using the survival, continence and potency (SCP) system for patients undergoing robot-assisted radical prostatectomy (RARP). MATERIAL AND METHODS: From 2009 to 2012, 232 patients underwent RARP. Self-reported continence, erection sufficient for intercourse (ESI) and scores on the five-item version of the International Index of Erectile Function-5 (IIEF-5) were registered by questionnaire and physician's interview preoperatively and at 3, 6 and 12 month follow-up, and subsequently on a yearly basis. Continence was defined as 0 pads, and potency as ESI or IIEF-5 greater than 17 with or without the aid of phosphodiesterase type 5 inhibitors. Oncological success was defined as absence of biochemical failure (BF) [prostate-specific antigen (PSA) ≥ 0.2 ng/ml]. The SCP system was used to evaluate combined oncological and functional outcomes. RESULTS: In total, 184 patients were followed for more than 1 year. The 12 month BF-free survival rate was 97.7%. Median time to regain continence was 6.2 months; 12 months postoperatively 79.9% used 0 pads/day. Of patients with preoperative ESI, 77.6% (67.9-86.1) and 34.4% (24.1-47.5) maintained ESI 12 months postoperatively after bilateral and unilateral nerve-sparing surgery (NS), respectively. NS (p < 0.0001), increasing prostate volume (p = 0.014) and lower age (p < 0.0001) were positively associated with recovery of potency. Using the SCP system and defining potency as ESI, functional and oncological success 12 months after surgery was achieved in 69 out of 135 (51.1%) preoperative continent and potent patients who underwent unilateral or bilateral NS, and did not require adjuvant treatment; when defining potency as IIEF greater than 17, this figure was 45 out of 108 (41.7%). As expected, the proportions were significantly higher for bilateral than for unilateral NS (p ≤ 0.0014). CONCLUSION: RARP provides good early BF-free survival, continence and potency recovery rates for patients eligible for NS. SN - 2168-1813 UR - https://www.unboundmedicine.com/medline/citation/24579803/Early_biochemical_recurrence_urinary_continence_and_potency_outcomes_following_robot_assisted_radical_prostatectomy_ L2 - https://www.tandfonline.com/doi/full/10.3109/21681805.2014.893534 DB - PRIME DP - Unbound Medicine ER -