[Is transition from pure laparoscopic to robotic-assisted radical prostatectomy associated with increase of surgical procedures for urinary incontinence and erectile dysfunction?]

Prog Urol. 2018 Dec;28(16):921-926. doi: 10.1016/j.purol.2018.08.008. Epub 2018 Sep 13.
[Article in French]

Abstract

Objective: To study the impact of changing the technique of radical prostatectomy [pure laparoscopic radical (PR-Lap) to robot-assisted radical prostatectomy (RP-Rob)] on the rate of secondary procedures for urinary incontinence (UI) and erectile dysfunction (ED).

Material: Retrospective study evaluating the number and type of surgical procedures for post-RP UI and DE between 2008 and 2015, according to the technique of (RP-Lap or RP-Rob).

Results: Between 2008 et 2015, 2046 RP were performed in our department including 372 RP-Lap and 1674 RP-Rob. Among these patients, 84 (4%) had a surgical procedure for post-RP UI (18 AMS800, 9 balloons Pro-Act, and 57 male slings) and 15 (0.7%) had implantation of penile prosthesis for post-RP ED; 16 (0.7%) patients had both procedures. The mean delay between RP and UI surgery decrease from 3.2 years in 2008 to 1 year in 2015 and remain stable for penile prosthesis implantation (mean delay: 3.4 years). The overall rates of secondary procedures for UI and DE remained stable and below 5% and 1.7%, respectively, even during the transition period. For each year of PR studied, the rates of secondary procedure were higher in the RP-Lap group.

Conclusion: Changing the technique of RP from RP-Lap to PR-Rob has a favorable impact on the rate of secondary procedures for UI and ED from the outset.

Keywords: Chirurgie robot-assistée; Dysfonction érectile; Erectile dysfunction; Incontinence urinaire; Laparoscopie; Laparoscopy; Prostatectomie totale; Radical prostatectomy; Robot-assisted surgery; Urinary incontinence.

MeSH terms

  • Aged
  • Erectile Dysfunction* / epidemiology
  • Erectile Dysfunction* / surgery
  • Humans
  • Laparoscopy* / adverse effects
  • Laparoscopy* / methods
  • Laparoscopy* / statistics & numerical data
  • Male
  • Middle Aged
  • Penile Implantation / statistics & numerical data
  • Penile Prosthesis / statistics & numerical data
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / etiology
  • Postoperative Complications* / surgery
  • Prostatectomy / adverse effects
  • Prostatectomy / instrumentation
  • Prostatectomy / methods*
  • Prostatectomy / statistics & numerical data*
  • Reoperation / methods
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Robotic Surgical Procedures* / adverse effects
  • Robotic Surgical Procedures* / methods
  • Robotic Surgical Procedures* / statistics & numerical data
  • Urinary Incontinence* / epidemiology
  • Urinary Incontinence* / surgery
  • Urologic Surgical Procedures, Male / instrumentation
  • Urologic Surgical Procedures, Male / methods
  • Urologic Surgical Procedures, Male / statistics & numerical data
  • Urologic Surgical Procedures, Male / trends