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1018 Difficult radical prostatectomy did not cause inferior functional outcome
1018
Difficult radical prostatectomy did not cause inferior functional outcome Eur Urol Suppl 2013;12;e1018
Michl U.H.G., Graefen M., Haese A., Salomon G., Heinzer H., Schlomm T., Steuber T., Huland H. Martini-Clinic, Dept. of Urology, Hamburg, Germany INTRODUCTION & OBJECTIVES: Radical prostatectomy could be verry difficult due to overweigt, dense adhesions, or prominent vascular structures resulting in an increase in operating time. Little is known, if this confers to interior functional results. The objective of this study was the evaluation of the effect of the difficulty of radical prostatectomy measured by the duration of the procedure on functional outcome. MATERIAL & METHODS: Between January 2005 and June 2011, nerve sparing prostatectomy was perfomed by 8 high volume surgeons in 9241 patients. For each surgeon, quartiles of the time needed for a procedure without lymphadenectomy were calculated. Functional results were obtained by standarized questionnaires and compared to the quartiles. RESULTS: Of the 9241 patients, 2807 were operated without lymphadenectomy and had their questionnaires returned. Quartiles ot the time (min) neede for operation were: Q1: 140.2 + 23.8, Q2: 165.4 + 24.0, Q3: 186.8 + 25.7; Q4: 231.9 + 50.7. Patients PSA slightly increased with increasing time(p: 0.0173). as did BMI (p: 0.004), and blood loss (p< 0.001), while age and prostate volume were not different. On final pathology, there was no difference in tumor stage, gleason grade, and margin status between the four groups. Continence one week after removal of the catheter was excellent, and there was no difference between the groups (Fig 1). IIEF 5 score at one year following surgery comparable results (Fig 2). Fig. 1: Pad use ONE WEEK after removal of the catheter
Fig. 2: IIEF 5 score at one year
CONCLUSIONS: Difficult surgery as measured by time needed for surgery did not cause inerior functional results. If one spend the excess time necessary for a difficult procedure, he will get excellent functional results in difficult cases too.
Difficult radical prostatectomy did not cause inferior functional outcome Eur Urol Suppl 2013;12;e1018
Michl U.H.G., Graefen M., Haese A., Salomon G., Heinzer H., Schlomm T., Steuber T., Huland H. Martini-Clinic, Dept. of Urology, Hamburg, Germany INTRODUCTION & OBJECTIVES: Radical prostatectomy could be verry difficult due to overweigt, dense adhesions, or prominent vascular structures resulting in an increase in operating time. Little is known, if this confers to interior functional results. The objective of this study was the evaluation of the effect of the difficulty of radical prostatectomy measured by the duration of the procedure on functional outcome. MATERIAL & METHODS: Between January 2005 and June 2011, nerve sparing prostatectomy was perfomed by 8 high volume surgeons in 9241 patients. For each surgeon, quartiles of the time needed for a procedure without lymphadenectomy were calculated. Functional results were obtained by standarized questionnaires and compared to the quartiles. RESULTS: Of the 9241 patients, 2807 were operated without lymphadenectomy and had their questionnaires returned. Quartiles ot the time (min) neede for operation were: Q1: 140.2 + 23.8, Q2: 165.4 + 24.0, Q3: 186.8 + 25.7; Q4: 231.9 + 50.7. Patients PSA slightly increased with increasing time(p: 0.0173). as did BMI (p: 0.004), and blood loss (p< 0.001), while age and prostate volume were not different. On final pathology, there was no difference in tumor stage, gleason grade, and margin status between the four groups. Continence one week after removal of the catheter was excellent, and there was no difference between the groups (Fig 1). IIEF 5 score at one year following surgery comparable results (Fig 2). Fig. 1: Pad use ONE WEEK after removal of the catheter
Fig. 2: IIEF 5 score at one year
CONCLUSIONS: Difficult surgery as measured by time needed for surgery did not cause inerior functional results. If one spend the excess time necessary for a difficult procedure, he will get excellent functional results in difficult cases too.