Comparison of functional outcomes between laparoscopic radical prostatectomy and robot‐assisted laparoscopic radical prostatectomy: a propensity score‐matched comparison study

• Published in: Asia-Pacific journal of clinical oncology Vol. 13; no. 3; pp. 212 - 218
• Main Authors: Ku, Ja Yoon, Lee, Chan Ho, Lee, Jeong Zoo, Ha, Hong Koo
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01.06.2017
• Subjects: Aged; Androgens; erectile dysfunction; Humans; Laparoscopy; Laparoscopy - methods; Male; Middle Aged; Propensity Score; Prostate; Prostate cancer; Prostatectomy; Prostatectomy - methods; prostatic neoplasms; Prostatic Neoplasms - pathology; Prostatic Neoplasms - surgery; Robotic surgery; Robotic Surgical Procedures - methods; Robotics; Surgery; Treatment Outcome; urinary incontinence; urination disorders; robotics; urinary incontinence; urination disorders; prostatic neoplasms; erectile dysfunction
• ISSN: 1743-7555; 1743-7563
• DOI: 10.1111/ajco.12595

Aim To compare the functional outcomes after laparoscopic radical prostatectomy (LRP) and robot‐assisted laparoscopic radical prostatectomy (RARP). Methods Between September 2008 and January 2016, 712 patients underwent radical prostatectomy (RP; 614 LRP and 98 RARP). Recovery of incontinence was evaluated through a 24‐h pad test. Urinary and erectile function was evaluated using the International Prostate Symptom Score (IPSS) and the International Index of Erectile Function‐5. Follow‐up interval was 1, 3, 6 and 12 months after the surgery. The propensity score matching was used to balance the preoperative characteristics. Results The recovery of incontinence was similar to the two groups at 6 and 12 months after the surgery. However, patients underwent RARP restored the continence sooner than those in the LRP group in 1 and 3 months after the surgery (P < 0.001 and 0.001). For the multivariable analysis, the type of RP procedure was a uniquely meaningful contributing factor (P = 0.001, HR = 1.925; 95% CI, 1.299–2.851). In the case of urinary function, the RARP groups showed a better IPSS score than LRP groups at the 1‐, 3‐ and 6‐month visits, respectively (P = 0.008, 0.026, 0.001), and the RARP groups early improved compared with LRP groups at the 3‐month visit in the case of erectile function (P = 0.018). Conclusion The RARP tended toward getting back the urinary continence earlier than the LRP. In addition, urinary and erectile function recovered more quickly in the RARP group than in the LRP group.