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Retzius-Sparing Robot-Assisted Radical Prostatectomy

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Comparing Patient-reported Functional Outcomes After Radical Prostatectomy in Historical and Contemporary Practice.

Udit Singhal^1,2, Brent K Hollenbeck¹, Samuel D Kaffenberger¹

¹Department of Urology, Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan.

The Journal of Urology

|August 11, 2023

Summary

This summary is machine-generated.

Modern prostate cancer surgery improves sexual function recovery but not urinary function. Contemporary patients had worse baseline health but better sexual outcomes post-radical prostatectomy compared to historical cohorts.

Keywords:

patient reported outcome measures physiological prostatectomy prostatic neoplasms sexual dysfunction urinary incontinence

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Area of Science:

Urology
Surgical Oncology
Patient Outcomes

Background:

Radical prostatectomy for prostate cancer significantly impacts urinary and sexual function.
Advancements in surgical techniques, including robotic surgery, aim to improve functional recovery.
Limited data exists comparing historical and contemporary practices regarding functional outcomes.

Purpose of the Study:

To evaluate the cumulative effect of surgical technique modifications on urinary and sexual function recovery after radical prostatectomy.
To compare functional outcomes between historical and contemporary prostate cancer surgery cohorts.

Main Methods:

Prospective patient-reported outcomes were compared between a historical cohort (PROSTQA, n=235) and a contemporary registry (MUSIC-PRO, n=1,215).
Urinary and sexual function were assessed at baseline and up to 24 months post-surgery.
Statistical analysis was performed to identify differences in recovery patterns between the groups.

Main Results:

Contemporary patients (MUSIC-PRO) had worse baseline urinary and sexual function compared to historical patients (PROSTQA).
No significant difference was observed in the pattern of urinary incontinence recovery between the two groups (P = .14).
Significant improvement in sexual function recovery was noted in the contemporary group compared to the historical group (P < .0001).
Contemporary cohorts presented with more unfavorable demographic and clinical characteristics.

Conclusions:

Surgical advancements over the past two decades have led to improved sexual function recovery after radical prostatectomy.
Urinary function recovery has not shown significant improvement despite surgical modifications.
Contemporary surgical practice achieves better sexual outcomes even with patients presenting with more complex health profiles.