title: Understanding early functional recovery after robotic prostatectomy.
abstract: OBJECTIVE
  The time to regain urinary control and sexual function after robotic-assisted prostatectomy varies widely. The authors performed a study to prospectively assess relationships between intraoperative processes and early functional recovery after surgery.
  
  
  METHODS
  Prostate cancer patients undergoing robotic prostatectomy prospectively completed questionnaires (Expanded Prostate Cancer Index Composite-Short Form, Sexual Health Inventory for Men) preoperatively and at 3 months postoperatively. Relationships between intraoperative processes and early recovery were measured using multiple logistic regression.
  
  
  RESULTS
  At 3 months, 73.9% and 29.7% of patients had recovered urinary and sexual function, respectively. Bladder neck preservation was associated with early recovery of both urinary and sexual function (P < .01). The quality of nerve sparing (P = .01), seminal vesicle sparing (P = .03), and the use of urethral suspension (P = .04) were associated with early recovery of sexual function.
  
  
  CONCLUSIONS
  Early functional recovery for patients undergoing robotic-assisted prostatectomy varies by both patient characteristics and process measures. The causal link between intraoperative processes and patient outcomes merits further study through quality improvement collaboratives.
authors.affiliation: Department of Urology, Division of Oncology, University of Michigan, Ann Arbor, MI 48109, USA.
authors.forename: Ted A
authors.initials: TA
authors.lastname: Skolarus
authors.forename: Alon Z
authors.initials: AZ
authors.lastname: Weizer
authors.forename: Ryan C
authors.initials: RC
authors.lastname: Hedgepeth
authors.forename: Chang
authors.initials: C
authors.lastname: He
authors.forename: David P
authors.initials: DP
authors.lastname: Wood
authors.forename: Brent K
authors.initials: BK
authors.lastname: Hollenbeck
mesh_terms: D000368:Aged; D007172:Erectile Dysfunction / Q000209:etiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D011788:Quality of Life; D020127:Recovery of Function; D012371:Robotics; D011795:Surveys and Questionnaires; D014555:Urination Disorders / Q000209:etiology