Date of Award

January 2021

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Preston C. Sprenkle

Abstract

Robot-assisted laparoscopic prostatectomy (RALP) is a potentially curative surgical intervention for men with clinically localized prostate cancer. Although RALP can provide excellent oncological outcomes, it is also associated with detrimental effects to functional outcomes, particularly urinary continence, which negatively impact post-operative quality of life. The purpose of this study is to identify the degree to which pre-operative patient factors, tumor characteristics, and surgical technique influenced the post-operative return of urinary continence in men undergoing RALP performed by a single surgeon for the treatment of clinically localized prostate cancer. We analyzed 182 consecutive patients with clinically localized prostate cancer who were treated with RALP between April 2013 and September 2020. A retrospective chart review was performed to evaluate pre-operative patient and tumor characteristics, as well as post-operative urinary continence. Achievement of urinary continence was defined as wearing no pads or an occasional security pad by patient-reported daily pad usage within 3 (early) and 12 months (late) after RALP. Postoperatively, 68 (37.3%) and 120 (78.9%) men achieved early and late recovery of continence, respectively. Multivariate logistic regression analyses revealed that Retzius sparing approach (OR 2.995; 95% CI 1.265 – 7.089; p = 0.013) and lower BMI (OR 0.823; 95% CI 0.823 – 0.988; p = 0.027) were associated with continence at 3 months post-operatively, while longer pre-operative membranous urethral length (OR 1.205; 95% CI 1.003 – 1.448; p = 0.047) and younger age (OR 0.907; 95% CI 0.824 – 0.998; p = 0.044) were associated with continence at 12 months post-operatively.

Comments

This is an Open Access Thesis.

Download
Open Access

This Article is Open Access

Share

COinS