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Age-stratified outcomes after robotic-assisted laparoscopic radical prostatectomy
Authors:Kevin C. Zorn  Frederick P. Mendiola  David E. Rapp  Albert A. Mikhail  Shang Lin  Marcelo A. Orvieto  Gregory P. Zagaja  Arieh L. Shalhav
Affiliation:(1) Section of Urology, Department of Surgery, University of Chicago, 5841 S. Maryland Ave. MC6038 J-653, Chicago, IL 60637, USA;(2) Department of Health Studies/Statistics, University of Chicago, Chicago, IL, USA
Abstract:
We sought to evaluate post-operative return of urinary and sexual function in men undergoing robotic-assisted laparoscopic radical prostatectomy (RLRP). Prospective assessment of urinary continence and sexual function was performed in patients undergoing RLRP. Subjective assessment involved the use of the validated RAND-36 Item Health Survey/UCLA Prostate Cancer Index questionnaire. Questionnaires were completed pre-operatively and at 1, 3, 6 and 12 months post-operatively. Subset analyses were performed to assess the effect of age on functional outcomes. A total of 338 consecutive patients underwent RLRP between February 2003 and August 2005. Included patients for evaluation comprised of 21, 129, and 150 patients, aged <50, 50–59, and ≥60 years old, respectively. Kaplan–Meier curve analysis demonstrated that younger men (<60 years) achieved subjective continence significantly earlier than older age group (≥60 years) (P = 0.02). Continence rates, however, equalized among all age groups at 1 year follow-up. Younger men (<50 years) also demonstrated a quicker and greater return of sexual function (P = 0.01), which persisted through assessment at 1 year post-operatively. Our results suggest that younger men may have an earlier return of continence and potency when compared to men > 60 years. Despite this finding, continence outcomes appear to be equal among age groups after 1 year of follow-up. Moreover, men < 60 years continue to report superior potency outcomes compared to men > 60 years at 1 year post-operatively. Such findings are valuable in counseling patients undergoing RLRP.
Keywords:Robotic prostatectomy  Potency  Continence  Quality of life
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