David T Tzou1, Bruce L Dalkin, Bea Anne Christopher, Haiyan Cui. 1. Department of Surgery, Section of Urology, Tucson Medical Center and Biometry Unit, Arizona Cancer Center, Arizona Health Sciences Center, Tucson, AZ 85712, USA.
Abstract
PURPOSE: To accurately assess the relationship between nerve sparing radical prostatectomy and urinary continence using an anonymous validated survey in men undergoing surgical treatment for prostate cancer. MATERIALS AND METHODS: From September 1999 to February 2006, men undergoing radical prostatectomy (RP) by one surgeon were given the UCLA Prostate Cancer Index to complete preop, and then annually thereafter to 2 years. We have 285 men who have completed the pre-op and year 1 and /or year 2 surveys. Continence was defined as requiring "no pads" on the survey. Analysis was based on attempted nerve sparing status of the surgery; none, unilateral, or bilateral. Subgroup analysis was then performed on successful nerve sparing surgery, defined as men responding they have an erection "firm enough for intercourse." RESULTS: Overall continence rates were 81% at year 1 and 87% at year 2. Attempted nerve sparing surgery, or successful nerve sparing surgery, did not result in better rates of continence than non-nerve sparing surgery. CONCLUSIONS: Using a validated survey with anonymous data collection, we found no improvement in continence, defined as pad-free, with attempted or successful nerve sparing RP. Based on our study, the goal of improving urinary outcomes should not be used as a justification for a nerve sparing template at radical prostatectomy.
PURPOSE: To accurately assess the relationship between nerve sparing radical prostatectomy and urinary continence using an anonymous validated survey in men undergoing surgical treatment for prostate cancer. MATERIALS AND METHODS: From September 1999 to February 2006, men undergoing radical prostatectomy (RP) by one surgeon were given the UCLA Prostate Cancer Index to complete preop, and then annually thereafter to 2 years. We have 285 men who have completed the pre-op and year 1 and /or year 2 surveys. Continence was defined as requiring "no pads" on the survey. Analysis was based on attempted nerve sparing status of the surgery; none, unilateral, or bilateral. Subgroup analysis was then performed on successful nerve sparing surgery, defined as men responding they have an erection "firm enough for intercourse." RESULTS: Overall continence rates were 81% at year 1 and 87% at year 2. Attempted nerve sparing surgery, or successful nerve sparing surgery, did not result in better rates of continence than non-nerve sparing surgery. CONCLUSIONS: Using a validated survey with anonymous data collection, we found no improvement in continence, defined as pad-free, with attempted or successful nerve sparing RP. Based on our study, the goal of improving urinary outcomes should not be used as a justification for a nerve sparing template at radical prostatectomy.
Authors: Donald L Pick; Kathryn Osann; Douglas Skarecky; Navneet Narula; David S Finley; Thomas E Ahlering Journal: BJU Int Date: 2011-01-18 Impact factor: 5.588