PURPOSE: To test the impact of surgeon experience on urinary continence (UC) recovery after robot-assisted radical prostatectomy (RARP). MATERIALS AND METHODS: The study included 1477 consecutive patients treated with RARP by four surgeons between 2006 and 2014. UC recovery was defined as being completely dry over a 24-hour period at follow-up. Surgeon experience was coded as the total number of RARP performed by the surgeon before the patient's operation. Multivariable analysis tested the association between surgeon experience and UC recovery. Covariates consisted of patient age, Charlson comorbidity index, preoperative International Index of Erectile Function-Erectile Function domain (IIEF-EF), nerve-sparing surgery (none vs unilateral vs bilateral), and preoperative risk groups (low- vs intermediate- vs high risk). RESULTS: The number of cases performed by each surgeon was 541, 413, 411, and 112, respectively. Median follow-up was 24 months (inter-quartile range: 18, 40). The UC recovery rate at 1 year after surgery was 82%. At multivariable analyses, surgeon experience represented an independent predictor of UC recovery (hazard ratio: 1.02, p < 0.001). The surgical learning curve was similar among surgeons, moving linearly from ∼60% of UC rate at the initial cases to almost 90% after more than 400 procedures. CONCLUSIONS: In patients undergoing RARP, surgeon experience is a significant predictor of UC recovery. The surgical learning curve of UC recovery does not reach a plateau even after more than 100 cases, suggesting a continuous improvement of the surgical technique. These findings deserve attention for patient counseling and future comparative studies evaluating functional outcomes after RARP.
PURPOSE: To test the impact of surgeon experience on urinary continence (UC) recovery after robot-assisted radical prostatectomy (RARP). MATERIALS AND METHODS: The study included 1477 consecutive patients treated with RARP by four surgeons between 2006 and 2014. UC recovery was defined as being completely dry over a 24-hour period at follow-up. Surgeon experience was coded as the total number of RARP performed by the surgeon before the patient's operation. Multivariable analysis tested the association between surgeon experience and UC recovery. Covariates consisted of patient age, Charlson comorbidity index, preoperative International Index of Erectile Function-Erectile Function domain (IIEF-EF), nerve-sparing surgery (none vs unilateral vs bilateral), and preoperative risk groups (low- vs intermediate- vs high risk). RESULTS: The number of cases performed by each surgeon was 541, 413, 411, and 112, respectively. Median follow-up was 24 months (inter-quartile range: 18, 40). The UC recovery rate at 1 year after surgery was 82%. At multivariable analyses, surgeon experience represented an independent predictor of UC recovery (hazard ratio: 1.02, p < 0.001). The surgical learning curve was similar among surgeons, moving linearly from ∼60% of UC rate at the initial cases to almost 90% after more than 400 procedures. CONCLUSIONS: In patients undergoing RARP, surgeon experience is a significant predictor of UC recovery. The surgical learning curve of UC recovery does not reach a plateau even after more than 100 cases, suggesting a continuous improvement of the surgical technique. These findings deserve attention for patient counseling and future comparative studies evaluating functional outcomes after RARP.
Authors: Nina Natascha Harke; Christian Wagner; Nikolaos Liakos; Katarina Urbanova; Mustapha Addali; Boris A Hadaschik; Jorn H Witt Journal: World J Urol Date: 2020-05-02 Impact factor: 4.226
Authors: Margaretha A van der Slot; Michael A den Bakker; Sjoerd Klaver; Mike Kliffen; Martijn B Busstra; John B W Rietbergen; Melanie Gan; Karen E Hamoen; Leo M Budel; Natascha N T Goemaere; Chris H Bangma; Jozien Helleman; Monique J Roobol; Geert J L H van Leenders Journal: Histopathology Date: 2020-09-03 Impact factor: 5.087
Authors: Melanie A Lindenberg; Valesca P Retèl; Henk G van der Poel; Ferdau Bandstra; Carl Wijburg; Wim H van Harten Journal: Sci Rep Date: 2022-05-10 Impact factor: 4.996
Authors: Faris F Brkic; Boban M Erovic; Arina Onoprienko; Stefan Janik; Dominik Riss; Claudia Lill; Stefan Grasl; Jafar-Sasan Hamzavi; Erich Vyskocil Journal: PLoS One Date: 2021-02-23 Impact factor: 3.240