Impact of Nerve Sparing Technique on Patient Self-Assessed Outcomes After Radical Perineal Prostatectomy

No AccessJournal of UrologyAdult urology1 Aug 2007Impact of Nerve Sparing Technique on Patient Self-Assessed Outcomes After Radical Perineal Prostatectomyis accompanied byRadical Prostatectomy: A Current Perspective Hubert R. Kübler, Timothy Y. Tseng, Leon Sun, Johannes Vieweg, Michael J. Harris, and Philipp Dahm Hubert R. KüblerHubert R. Kübler Department of Urology, University of Florida, Gainesville, Florida , Timothy Y. TsengTimothy Y. Tseng Division of Urologic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina , Leon SunLeon Sun Division of Urologic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina , Johannes ViewegJohannes Vieweg Department of Urology, University of Florida, Gainesville, Florida , Michael J. HarrisMichael J. Harris Northern Institute of Urology, Traverse City, Michigan , and Philipp DahmPhilipp Dahm Department of Urology, University of Florida, Gainesville, Florida View All Author Informationhttps://doi.org/10.1016/j.juro.2007.03.100AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We investigated the impact of nerve sparing technique on erectile function, urinary continence and health related quality of life after radical perineal prostatectomy using a validated self-assessment questionnaire. Materials and Methods: The Expanded Prostate Cancer Index Composite questionnaire was administered preoperatively and at defined intervals after surgery to 265 patients who underwent radical perineal prostatectomy at 2 institutions between January 2001 and December 2004. Of these patients 153 (57.7%) and 112 (42.3%) underwent nonnerve sparing and nerve sparing approaches, respectively. Kaplan-Meier analysis was used to determine time to recovery of erectile function (erections firm enough for intercourse) and urinary continence (0 pads per day). Results: Median patient age was 60.6 years. Median followup was 15 months. In multivariate analysis preoperative erectile function (p = 0.005) and preservation of the neurovascular bundle (p = 0.018) were independent predictors of earlier recovery of erectile function, with hazard ratios of 2.3 (95% CI 1.2–4.6) and 4.0 (95% CI 1.5–10.3), respectively. Median time to recovery of urinary continence was 4.8 months in the nerve sparing group and 6.1 months in the nonnerve sparing group (p = 0.001). In multivariate analysis nerve sparing technique (p = 0.001, HR 1.4, 95% CI 1.1–1.9) and age (p = 0.012, HR 1.7, 95% CI 1.3–2.2) were independent predictors of recovery of continence. 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Link, Google Scholar © 2007 by American Urological AssociationFiguresReferencesRelatedDetailsCited byNguyen L, Head L, Witiuk K, Punjani N, Mallick R, Cnossen S, Fergusson D, Cagiannos I, Lavallée L, Morash C and Breau R (2017) The Risks and Benefits of Cavernous Neurovascular Bundle Sparing during Radical Prostatectomy: A Systematic Review and Meta-AnalysisJournal of Urology, VOL. 198, NO. 4, (760-769), Online publication date: 1-Oct-2017.Ko Y, Coelho R, Chauhan S, Sivaraman A, Schatloff O, Cheon J and Patel V (2011) Factors Affecting Return of Continence 3 Months After Robot-Assisted Radical Prostatectomy: Analysis From a Large, Prospective Data by a Single SurgeonJournal of Urology, VOL. 187, NO. 1, (190-195), Online publication date: 1-Jan-2012.Mulhall J (2008) Defining and Reporting Erectile Function Outcomes After Radical Prostatectomy: Challenges and MisconceptionsJournal of Urology, VOL. 181, NO. 2, (462-471), Online publication date: 1-Feb-2009.Related articlesJournal of Urology11 Jun 2007Radical Prostatectomy: A Current Perspective Volume 178Issue 2August 2007Page: 488-492 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordsquality of lifeprostatic neoplasmsprostatectomyMetricsAuthor Information Hubert R. Kübler Department of Urology, University of Florida, Gainesville, Florida Equal study contribution. More articles by this author Timothy Y. Tseng Division of Urologic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina Equal study contribution. More articles by this author Leon Sun Division of Urologic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina More articles by this author Johannes Vieweg Department of Urology, University of Florida, Gainesville, Florida More articles by this author Michael J. Harris Northern Institute of Urology, Traverse City, Michigan Financial interest and/or other relationship with Glaxo-Smith-Kline. More articles by this author Philipp Dahm Department of Urology, University of Florida, Gainesville, Florida More articles by this author Expand All Advertisement PDF downloadLoading ...