Robotic prostatectomy cuts incontinence risk

Robot-assisted radical prostatectomy appears to provide better functional results for incontinence and potency, according to the authors of a study from Turin, Italy.

First author Francesco Porpiglia, MD, of San Luigi Gonzaga Hospital-Orbassano (Turin), University of Turin, and colleagues studied 120 patients with organ-confined prostate cancer who were randomly assigned to one of two groups of 60 men based on surgical approach: robot-assisted radical prostatectomy or laparoscopic radical prostatectomy. All interventions were performed with the same technique by the same single surgeon.

Demographic, perioperative, and pathologic results were recorded and compared. Continence was evaluated at the time of catheter removal and 48 hours later, and continence and potency were evaluated after 1, 3, 6, and 12 months.

No differences were recorded in terms of perioperative and pathologic results, complication rate, or PSA measurements. The continence rate was higher in the robotic prostatectomy group at every time point: continence after 3 months was 80% in the robotic surgery group and 61.6% in the laparoscopic surgery group (p=.044), and after 1 year, the continence rates were 95.0% and 83.3%, respectively (p=.042), as reported online in European Urology (July 20, 2012).

Among patients who were potent preoperatively and treated with nerve-sparing techniques, the rate of erection recovery was 80% and 54.2%, respectively (p=.020).

"This is certainly the strongest evidence to date [that] laparoscopic surgery done with robotic assistance is going to yield better outcomes than traditional laparoscopy," Matthew Cooperberg, MD, MPH, of the University of California, San Francisco, told Reuters Health. Dr. Cooperberg was not involved with the study.

Dr. Porpiglia noted to Reuters Health that, "Our results depend strictly on the single surgeon and do not represent a real-life situation."

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