Continence, potency and oncological outcomes after robotic-assisted radical prostatectomy: early trifecta results of a high-volume surgeon.
OBJECTIVE
• To evaluate early trifecta outcomes after robotic-assisted radical prostatectomy (RARP) performed by a high-volume surgeon.


METHODS
• We evaluated prospectively 1100 consecutive patients who underwent RARP performed by one surgeon. In all, 541 men were considered potent before RARP; of these 404 underwent bilateral full nerve sparing and were included in this analysis. • Baseline and postoperative urinary and sexual functions were assessed using self-administered validated questionnaires. • Postoperative continence was defined as the use of no pads; potency was defined as the ability to achieve and maintain satisfactory erections for sexual intercourse >50% of times, with or without the use of oral phosphodiesterase type 5 inhibitors; Biochemical recurrence (BCR) was defined as two consecutive PSA levels of >0.2 ng/mL after RARP. • Results were compared between three age groups: Group 1, ≤ 55 years, Group 2, 56-65 years and Group 3, >65 years.


RESULTS
• The trifecta rates at 6 weeks, 3, 6, 12, and 18 months after RARP were 42.8%, 65.3%, 80.3%, 86% and 91%, respectively. • There were no statistically significant differences in the continence and BCR-free rates between the three age groups at all postoperative intervals analysed. • Nevertheless, younger men had higher potency rates and shorter time to recovery of sexual function when compared with older men at 6 weeks, 3, 6 and 12 months after RARP (P < 0.01 at all time points). • Similarly, younger men had higher trifecta rates at 6 weeks, 3 and 6 months after RARP compared with older men (P < 0.01 at all time points).


CONCLUSIONS
• RARP offers excellent short-term trifecta outcomes when performed by an experienced surgeon. • Younger men had higher overall trifecta rates when compared with older men at 6 weeks, 3 and 6 months after RARP.
Patel
Vipul R
VR
Global Robotics Institute, Florida Hospital Celebration Health, University of Central Florida School of Medicine, Celebration, FL, USA. Vipul.patel.md@flhosp.org
Coelho
Rafael F
RF
Chauhan
Sanket
S
Orvieto
Marcelo A
MA
Palmer
Kenneth J
KJ
Rocco
Bernardo
B
Sivaraman
Ananthakrishnan
A
Coughlin
Geoff
G
D000368:Aged; D002983:Clinical Competence; D004812:Epidemiologic Methods; D007172:Erectile Dysfunction / Q000209:etiology* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000534:rehabilitation* / Q000601:surgery; D012371:Robotics; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology* / Q000534:rehabilitation
D058986:Phosphodiesterase 5 Inhibitors; D017430:Prostate-Specific Antigen