Cleveland-Patients undergoing laparoscopic radical prostatectomy can expect continuing improvement in urinary and sexual functions for up to 2 years after the procedure, according to a single-institution study from the Johns Hopkins Medical Institutions in Baltimore, presented here at the 2006 World Congress of Endourology.
While these findings are readily assumed by most urologists, few prospective studies following laparoscopic prostatectomy have been performed that give weight to those assumptions, said the study's lead author, Andrew A. Wagner, MD. Dr. Wagner, formerly at Johns Hopkins, is now director of minimally invasive urology surgery at Beth Israel Deaconess Medical Center in Boston.
"I think these data have to be kept in perspective. This is a single-institution study with the procedures performed by two experienced surgeons. The data from their institution may not apply in other settings. The surgeons who conducted the study can now provide their patients with honest and accurate assessments of the likelihood and timing of return of urinary and sexual function," Dr. Wagner told Urology Times. "If a similar laparoscopic technique is used, it is reasonable to assume patient outcomes would be similar in other tertiary care centers.
Steady improvement seen
To arrive at their conclusion, the Johns Hopkins team assessed sexual function and continence at baseline and at 6, 12, and 24 months in 443 patients undergoing laparoscopic radical prostatectomy performed by two urologists between March 2001 and March 2005.
Continence, as measured by pad use, steadily improved, with 82%, 87%, and 94% reporting using zero or one pad per day as the study progressed (6, 12, and 24 months, respectively). The mean urinary incontinence subscale (UIS), a global urinary function score based on the answers to several questions from the EPIC, was 76%, 77%, and 89% at 6, 12, and 24 months, respectively.