Comparación entre la prostatectomía con preservación del espacio de Retzius y la prostatectomía radical estándar asistida por robot para el cáncer de próstata / Comparison of Retzius-Sparing versus Standard Robot-Assisted Radical Prostatectomy for Prostate Cancer

Introducción y objetivos Nuestro objetivo fue comparar los resultados oncológicos y funcionales del primer año tras la prostatectomía radical asistida por robot con preservación del espacio de Retzius (PRAR-PR) y la prostatectomía radical estándar asistida por robot (PRAR). Materiales y métodos Se incluyeron 88 pacientes sometidos a prostatectomía radical robótica entre 2018-2019. Se compararon los resultados oncológicos y funcionales de los pacientes que recibieron PRAR-PR o PRAR durante un periodo mínimo de seguimiento de un año. La potencia se evaluó con la puntuación del cuestionario de salud sexual del varón (Sexual Health Inventory for Men) y se definió como una erección con rigidez suficiente para la penetración. La continencia se definió como la ausencia de incontinencia urinaria sin compresa de seguridad. Los pacientes fueron evaluados en el primer mes y trimestralmente durante el resto del seguimiento. Resultados Se incluyeron 46 pacientes en el grupo PRAR-PR y 42 en el grupo PRAR. El tiempo de retirada del catéter fue menor en el grupo PRAR-PR (12 vs. 14 días, p=0,001). En la consulta del primer mes 41 pacientes (89%) eran continentes (no utilizaban compresas) en el grupo PRAR-PR, mientras que 25 pacientes (59%) eran continentes en el grupo PRAR (p=0,001). Los pacientes sometidos a PRAR-PR lograron una recuperación más rápida de la continencia urinaria (Log-rank, p=0,001). Tras un año de seguimiento 43 pacientes (93%) del grupo PRAR-PR y 38 (90%) del grupo PRAR eran continentes (p=0,6). Las tasas de potencia fueron del 38,7% en el grupo PRAR-PR y del 34,4% en el grupo PRAR (p=0,28). No se observaron recurrencias bioquímicas en ningún grupo. Conclusiones La PRAR-PR es una técnica factible, que proporciona un retorno temprano de la continencia. Sin embargo, las tasas globales de continencia fueron similares al final del periodo de un año de seguimiento (AU)

Introduction and objectives We aim to compare the first year oncological and functional outcomes of Retzius-sparing robot-assisted radical prostatectomy (Rs-RARP) and standard robot-assisted radical prostatectomy (RARP). Materials and methods Eighty-eight patients who underwent robotic radical prostatectomy between 2018-2019 were included. We compared the minimum one-year follow-up results of patients who underwent Rs-RARP or RARP in terms of oncological and functional outcomes. Potency was assessed with the Sexual Health Inventory for Men (SHIM) score and was defined as an erection sufficient for penetration. Continence was defined as the absence of urinary incontinence with no safety pad. Patients were evaluated in the first month of follow-up and subsequently, every three months. Results Forty-six patients in Rs-RARP and 42 patients in the RARP group were enrolled. Catheter removal time was shorter in the Rs-RARP group (12 vs. 14 days, P=.001). At the 1st month visit, 41 patients (%89) were continent (no pads) in the Rs-RARP group while 25 patients (%59) were continent in the RARP group (P=.001). Patients who underwent Rs-RARP achieved faster recovery of urinary continence (Log-rank, P=.001). After one year of follow-up, 43 patients (93%) in Rs-RARP group and 38 patients (90%) in RARP group were continent (P=.6). Potency rates were 38.7% in Rs-RARP and 34.4% in RARP group (P=.28). There were no cases of biochemical recurrence in any group. Conclusions Rs-RARP is a feasible technique, providing early return of continence. However, overall continence rates were similar at the end of the one-year follow-up (AU)

Comparison of Retzius-sparing versus standard robot-assisted radical prostatectomy for prostate cancer.

INTRODUCTION AND OBJECTIVES: We aim to compare the first year oncological and functional outcomes of Retzius-sparing robot-assisted radical prostatectomy (Rs-RARP) and standard robot-assisted radical prostatectomy (RARP). MATERIALS AND METHODS: Eighty-eight patients who underwent robotic radical prostatectomy between 2018-2019 were included. We compared the minimum one-year follow-up results of patients who underwent Rs-RARP or RARP in terms of oncological and functional outcomes. Potency was assessed with the Sexual Health Inventory for Men (SHIM) score and was defined as an erection sufficient for penetration. Continence was defined as the absence of urinary incontinence with no safety pad. Patients were evaluated in the first month of follow-up and subsequently, every three months. RESULTS: Forty-six patients in Rs-RARP and 42 patients in the RARP group were enrolled. Catheter removal time was shorter in the Rs-RARP group (12 vs. 14 days, p = 0.001). At the 1st month visit, 41 patients (%89) were continent (no pads) in the Rs-RARP group while 25 patients (%59) were continent in the RARP group (p = 0.001). Patients who underwent Rs-RARP achieved faster recovery of urinary continence (Log-rank, p = 0.001). After one year of follow-up, 43 patients (93%) in Rs-RARP group and 38 patients (90%) in RARP group were continent (p = 0.6). Potency rates were 38.7% in Rs-RARP and 34.4% in RARP group (p = 0.28). There were no cases of biochemical recurrence in any group. CONCLUSIONS: Rs-RARP is a feasible technique, providing early return of continence. However, overall continence rates were similar at the end of the one-year follow-up.

Erectile dysfunction patients are more satisfied with penile prosthesis implantation compared with tadalafil and intracavernosal injection treatments.

There are various treatment modalities for erectile dysfunction with different success and satisfaction rates. We aim to compare patient satisfaction with tadalafil, intracavernosal injection, and penile prosthesis implantation in patients with erectile dysfunction. The records of 3448 men with erectile dysfunction were evaluated retrospectively. A total of 356 men with organic erectile dysfunction were enrolled into this study. Of these patients, 132 (37%) received tadalafil 20 mg twice a week for 12 weeks, 106 (30%) patients received tadalafil 5 mg once-daily for 12 weeks, 96 (27%) patients used intracavernosal injection therapy (Bi-mix; papaverine and phentolamine). Moreover, 22 patients underwent penile prosthesis implantation. Patient and partner satisfaction were assessed with International Index of Erectile Function (IIEF) and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire. Patients' mean age was 52.4 ± 25.76 (32-71). The etiology of erectile dysfunction was chronic systemic diseases in 133 (44%) and radical prostatectomy in 121 patients (40%). The mean IIEF-5 scores improvement after the treatment was higher in penile prosthesis implantation group (12.4 ± 1.3) compared with tadalafil 5 mg (6.7 ± 1.5) (p < 0.01), tadalafil 20 mg (6.2 ± 1.5) (p < 0.01), and intracavernosal injection group (8.4 ± 3.2) (p < 0.05). The EDITS score was significantly higher in penile prosthesis implantation group (78.2 ± 11.3) compared with intracavernosal injection (60.3 ± 6.3), tadalafil 5 mg (72.5 ± 4.5), and tadalafil 20 mg 70.7 ± 3.4 groups (p < 0.05). Partners' EDITS scores were 70.1 ± 10 in penile prosthesis implantation group, 50.2 ± 1.5 in intracavernosal injection group, 62.9 ± 7.8 in tadalafil 5 mg, and 61.3 ± 5.3 in tadalafil 20 mg group (p < 0.05). Erectile dysfunction patients who underwent penile prosthesis implantation seem to be more satisfied compared with tadalafil treatment and intracavernosal injection. Future clinical trials are warranted to confirm our results.