Patient reported functional outcomes following robotic-assisted (RARP), laparoscopic (LRP), and open radical prostatectomies (ORP)

• Published in: Irish journal of medical science Vol. 186; no. 4; pp. 835 - 840
• Main Authors: Nason, G. J., O’Kelly, F., White, S., Dunne, E., Smyth, G. P., Power, R. E.
• Format: Journal Article
• Language: English
• Published: London Springer London 01-11-2017
• Subjects: Aged; Family Medicine; General Practice; Humans; Internal Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Patient Reported Outcome Measures; Prospective Studies; Prostatectomy - methods; Prostatic Neoplasms - pathology; Prostatic Neoplasms - surgery; Retrospective Studies; Robotic Surgical Procedures - methods; Treatment Outcome; Urinary incontinence; Erectile dysfunction; Radical prostatectomy; Prostate cancer; Functional outcomes
• ISSN: 0021-1265; 1863-4362
• DOI: 10.1007/s11845-016-1522-7

Background
Radical prostatectomy for prostate cancer is associated with significant complications, such as urinary incontinence and erectile dysfunction. Debate remains regarding the influence of surgical technique on these important functional outcomes.
Aim
The aim of this study was to compare the early functional outcomes following robotic-assisted (RARP), laparoscopic (LRP), and open radical prostatectomy (ORP) in a rapid access cohort.
Methods
A retrospective review of a prospectively maintained database was performed between 2011 and 2014. Functional status was objectively assessed using the International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF-5), and a self-reported continence score.
Results
Two hundred and ninety-two patients underwent RP (85 RARP, 100 LRP, 107 ORP). The mean age was 61.3 years with a mean initial PSA was 6.2 ng/ml. There was no difference noted in urinary function between ORP, LRP, and RARP at 3 months (
p
 = 0.894), 6 months (
p
 = 0.244), 9 months (
p
 = 0.068) or 12 months (
p
 = 0.154). All men noted a deterioration in erectile function; however, there was no difference at 3 months (
p
 = 0.922), 6 months (
p
 = 0.723), 9 months (
p
 = 0.101) or 12 months (
p
 = 0.395),
Conclusion
Equivalent good early functional outcomes are being achieved in patients undergoing RP irrespective of surgical approach. Longer follow-up in a prospective randomized fashion is required to fully assess the most appropriate surgical technique.