Title

Cavernosal Nerve Preservation During Robot-Assisted Radical Prostatectomy Is A Graded Rather Than An All-Or-None Phenomenon: Objective Demonstration By Assessment Of Residual Nerve Tissue On Surgical Specimens

Abstract

Purpose: To determine whether the presence of median lobe (ML) affects perioperative outcomes, positive surgical margin (PSM) rates, and recovery of urinary continence after robot-assisted radical prostatectomy (RARP). Patients and Methods: We analyzed 1693 consecutive patients undergoing RARP performed by a single surgeon. Patients were analyzed in two groups based on the presence or not of a ML identified during RARP. Perioperative outcomes, PSM rates, and recovery of urinary continence were compared between the groups. Continence was assessed using validated questionnaires, and it was defined as the use of "no pads" postoperatively. Results: A ML was identified in 323 (19%) patients. Both groups had similar estimated blood loss, length of hospital stay, pathologic stage, complication rates, anastomotic leakage rates, overall PSM rates, and PSM rate at the bladder neck. The median overall operative time was slightly greater in patients with ML (80 vs 75min, P<0.001); however, there was no difference in the operative time when stratifying this result by prostate weight. Continence rates were also similar between patients with and without ML at 1 week (27.8% vs 27%, P=0.870), 4 weeks (42.3% vs 48%, P=0.136), 12 weeks (82.5% vs 86.8%, P=0.107), and 24 weeks (91.5% vs 94.1%, P=0.183) after catheter removal. Finally, the median time to recovery of continence was similar between the groups (median: 5wks, 95% confidence interval [CI]: 4.41-5.59 vs median: 5wks, CI 4.66-5.34; log rank test, P=0.113). Conclusion: The presence of a ML does not affect outcomes of RARP performed by an experienced surgeon. © 2012, Mary Ann Liebert, Inc.

Publication Date

3-1-2012

Publication Title

Urology

Volume

79

Issue

3

Number of Pages

596-600

Document Type

Article

Personal Identifier

scopus

DOI Link

https://doi.org/10.1016/j.urology.2011.11.029

Socpus ID

84857842555 (Scopus)

Source API URL

https://api.elsevier.com/content/abstract/scopus_id/84857842555

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