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Preoperative Criteria to Select Patients for Bilateral Nerve-sparing Robotic-assisted Radical Prostatectomy
- Publication Year :
- 2010
- Publisher :
- Malden, MA : Blackwell Publishing, Inc, 2010.
-
Abstract
- 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.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.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-upor =12 months.Twelve-month potency rate after RALP, defined as an International Index of Erectile Function 6 (IIEF-6) scoreor =18.Data showed that 129 out of 208 enrolled patients (62%) were potent 12 months after surgery. Age (hazard ratio [HR]: 2.8; P0.001), Charlson score (HR: 2.9; P = 0.007), and baseline IIEF-6 score (HR: 0.8; P0.001) 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 (P0.001).In the era of robotic surgery, the key point for the success of the nerve-sparing technique remains the accurate selection of patients. Ageor =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.
- Subjects :
- Male
medicine.medical_specialty
Nerve sparing
Laparoscopic radical prostatectomy
RALP
Urology
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
Prostate cancer
robot-assisted laparoscopic prostatectomy
Postoperative Complications
Endocrinology
Erectile Dysfunction
Risk Factors
robotic surgery
Health Status Indicators
Humans
Medicine
Potency
Robotic surgery
Prostatectomy
prostate cancer
nerve-sparing robotic-assisted radical prostatectomy
erectile function
business.industry
Patient Selection
Hazard ratio
Prostatic Neoplasms
Robotics
Erectile function
medicine.disease
Surgery
Psychiatry and Mental health
Surgery, Computer-Assisted
Reproductive Medicine
Laparoscopy
business
Follow-Up Studies
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....7cc24049b356a21c4ffcb8f2ff3df397