Trifecta outcomes after robot-assisted laparoscopic radical prostatectomy.

Area of Science:

• Urology
• Oncology
• Surgical Innovation

Background:

• Robot-assisted laparoscopic radical prostatectomy (RALP) is a widely adopted treatment for localized prostate cancer.
• Evaluating functional outcomes, such as continence and potency, is crucial for assessing RALP success.
• The 'trifecta' outcome (continence, potency, and cancer control) is a key metric for comprehensive RALP evaluation.

Purpose of the Study:

• To determine the trifecta outcome rate in patients undergoing RALP.
• To identify preoperative predictors associated with achieving the trifecta outcome after RALP.

Main Methods:

• Prospective data collection from 242 patients undergoing RALP with at least 12-month follow-up.
• Functional outcomes assessed using validated questionnaires: ICIQ-UI SF for continence and IIEF-6 for erectile function.
• Logistic regression (univariable and multivariable) used to analyze predictors of the trifecta outcome.

Main Results:

• The trifecta outcome was achieved by 57% of patients at 12 months post-surgery.
• Continence (89%) and potency (60%) rates were reported at 12 months.
• Multivariable analysis identified younger patient age at surgery and higher preoperative erectile function (IIEF-6) as independent predictors of trifecta success.

Conclusions:

• Nerve-sparing RALP can achieve trifecta outcomes in a significant proportion of patients.
• Patient age and preoperative erectile function are critical factors influencing trifecta success post-RALP.
• These findings aid in patient counseling and surgical planning for RALP.