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POTENCY, CONTINENCE AND COMPLICATION RATES IN 1,870 CONSECUTIVE RADICAL RETROPUBIC PROSTATECTOMIES

1999; Lippincott Williams & Wilkins; Volume: 162; Issue: 2 Linguagem: Inglês

10.1016/s0022-5347(05)68578-3

1527-3792

William J. Catàlona, Gustavo Franco Carvalhal, DOUGLAS E. MAGER, Deborah S. Smith,

Advanced Radiotherapy Techniques

No AccessJournal of UrologySociety of Urologic Oncology1 Aug 1999POTENCY, CONTINENCE AND COMPLICATION RATES IN 1,870 CONSECUTIVE RADICAL RETROPUBIC PROSTATECTOMIES WILLIAM J. CATALONA, GUSTAVO F. CARVALHAL, DOUGLAS E. MAGER, and DEBORAH S. SMITH WILLIAM J. CATALONAWILLIAM J. CATALONA More articles by this author , GUSTAVO F. CARVALHALGUSTAVO F. CARVALHAL More articles by this author , DOUGLAS E. MAGERDOUGLAS E. MAGER More articles by this author , and DEBORAH S. SMITHDEBORAH S. SMITH More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)68578-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We update results in a series of consecutive patients treated with anatomic radical retropubic prostatectomy regarding recovery of erections, urinary continence and postoperative complications. Materials and Methods: One surgeon performed anatomic radical retropubic prostatectomy on 1,870 men, using the nerve sparing modification when feasible. We evaluate recovery of erections and urinary continence in men followed for a minimum of 18 months. Patients who were not reliably potent before surgery, did not undergo a nerve sparing procedure, or received hormonal therapy or postoperative adjuvant radiotherapy were excluded from the analysis of potency rates but not of continence rates. Other postoperative complications were evaluated for the entire patient population. Results: Recovery of erections occurred in 68% of preoperatively potent men treated with bilateral (543 of 798) and 47% treated with unilateral (28 of 60) nerve sparing surgery. Recovery of erections was more likely with bilateral than with unilateral nerve sparing surgery in patients less than 70 years old (71 versus 48%, p <0.001) compared with patients with age 70 years old or older (48 versus 40%, p = 0.6). Recovery of urinary continence occurred in 92% (1,223 of 1,325 men) and was associated with younger age (p <0.0001) but not with tumor stage (p = 0.2) or nerve sparing surgery (p = 0.3). Postoperative complications occurred in 10% of patients overall and were associated with older age (p <0.002) but the incidence declined significantly with increasing experience of the surgeon (p <0.0001). There was no operative mortality. Conclusions: Anatomic radical retropubic prostatectomy with the nerve sparing modification can be performed with favorable results in preserving potency and urinary continence. Better results are achieved in young men with organ confined cancer. Other complications can be reduced with increasing surgeon experience. References 1 : Impotence following radical prostatectomy: insight into etiology and prevention. J. Urol.1982; 128: 492. Link, Google Scholar 2 : Impact of anatomical radical prostatectomy on urinary continence. J. Urol.1991; 145: 512. 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Volume 162Issue 2August 1999Page: 433-438 Advertisement Copyright & Permissions© 1999 by American Urological Association, Inc.MetricsAuthor Information WILLIAM J. CATALONA More articles by this author GUSTAVO F. CARVALHAL More articles by this author DOUGLAS E. MAGER More articles by this author DEBORAH S. SMITH More articles by this author Expand All Advertisement PDF downloadLoading ...