Functional outcomes in African-Americans after robot-assisted radical prostatectomy.
OBJECTIVE
Previous studies have demonstrated differences in surgical outcomes after radical prostatectomy based on ethnicity. We compared sexual and urinary outcomes in African-American (AA) patients 6 and 12 months after robot-assisted radical prostatectomy (RARP) with those of non-AA patients.


METHODS
We reviewed our RARP database at our institution for patients with at least 12 months of follow-up. Erectile function was defined using the University of California, Los Angeles Prostate Cancer Index as erections "firm enough for masturbation and foreplay" or "firm enough for intercourse," while urinary continence was defined as being "pad free." Only patients who were potent and pad free preoperatively were included in the analysis. Multivariate logistic regression was used to compare postoperative potency and urinary pad-free status between AA and non-AA patients while controlling for pertinent demographic, clinical, and pathologic variables.


RESULTS
In the urinary continence analysis, 140 AA patients and 576 non-AA patients were included, compared with 105 AAs and 500 non-AA patients who were included in the analysis of sexual function. At 12 months postoperatively, a smaller proportion of AA patients were potent compared with non-AA patients (60% vs 76.4%, P=0.001). Similarly, we found a lower incidence of pad-free status for AA patients at 12 months postoperatively (55.7% vs 69.8%, P=0.039). Similar functional results were found at 6 months postoperatively for both analysis groups.


CONCLUSIONS
AA men appear to have worse urinary and sexual outcomes at 12 months after RARP compared with non-AA patients. At 6 months, there is no statistically significant difference. Further, longer-term studies are needed to validate these results.
Department of Urology, New York Presybyterian Hospital, Columbia University, New York, New York, USA. gjd16@columbia.edu
G Joel
GJ
DeCastro
Gautam
G
Jayram
Aria
A
Razmaria
Arieh
A
Shalhav
Gregory P
GP
Zagaja
D000328:Adult; D001741:Black or African American; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011182:Postoperative Care; D011300:Preoperative Care; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000208:ethnology / Q000503:physiopathology* / Q000601:surgery*; D012371:Robotics / Q000379:methods*; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology / Q000503:physiopathology