title: Laparoscopic versus open bilateral intrafascial nerve-sparing radical prostatectomy after TUR-P for incidental prostate cancer: surgical outcomes and effect on postoperative urinary continence and sexual potency.
abstract: OBJECTIVE
  To evaluate the surgical and functional outcomes in nerve-sparing laparoscopic radical prostatectomy (nsLRPT) and nerve-sparing retropubic radical prostatectomy (nsRRPT) after TUR-P for incidental prostate cancer.
  
  
  METHODS
  Between January 2003 and August 2011, 125 nsLRPT and 128 nsRRPT for incidental prostate cancer diagnosed after TUR-P were performed at our clinic. Demographic data, peri- and postoperative measurements and functional outcomes were compared.
  
  
  RESULTS
  The mean operative time was 153.1 ± 35.4 min for nsLRPT and 122.5 ± 67.5 min for nsRRPT (p = 0.03). The mean catheterization time was 8 ± 1 days in the laparoscopic group and 11 ± 2 days in the open group (p = 0.02). Also, the length of hospitalization presents statistical significant difference in the two groups. Positive margins were detected in 2.4 and 4.7% of patients with pT2c tumours in the laparoscopic and open groups, respectively (p = 0.09). At a mean follow-up of 26.9 ± 9.3 months for the nsLRPT group and of 27.8 ± 9.7 months for the nsRRPT group, all patients were alive with no evidence of tumour recurrence. Twelve months postoperatively, complete continence was reported in 96.8% of patients who underwent an nsLRPT and in 89.4% of patients in the nsRRPT group (p = 0.02). At that time, 74.4% of patients in the nsLRPT group and 53.1% in the nsRRPT group reported the ability to engage in sexual intercourse (p = 0.0004).
  
  
  CONCLUSIONS
  nsLRPT after TUR-P, performed by expert surgeons, results to be a safe procedure with excellent functional outcomes with regard to the urinary continence and sexual potency.
authors: Department of Urology and Kidney Transplantation, Clinic of Urology, Martin-Luther-University, Ernst- Grube- Str. 40, 06120, Halle, Saale, Germany.
authors: Christopher
authors: C
authors: Springer
authors: Antonino
authors: A
authors: Inferrera
authors: Giovannalberto
authors: G
authors: Pini
authors: Nasreldin
authors: N
authors: Mohammed
authors: Paolo
authors: P
authors: Fornara
authors: Francesco
authors: F
authors: Greco
mesh_terms: D000368:Aged; D007172:Erectile Dysfunction / Q000453:epidemiology*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D033162:Incidental Findings; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D059351:Organ Sparing Treatments / Q000379:methods*; D011184:Postoperative Period; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000453:epidemiology*
references: Eur Urol. 2006 Jan;49(1):113-9
references: 16337330
references: Eur Urol. 2006 Dec;50(6):1278-82; discussion 1283-4
references: 16846677
references: BJU Int. 2007 Jun;99(6):1461-6
references: 17537217
references: Eur Urol. 2003 Oct;44(4):401-6
references: 14499672
references: BJU Int. 2010 Aug;106(4):543-7
references: 20067455
references: Urol Int. 2006;77(3):216-21
references: 17033208
references: Eur Urol. 2006 Jan;49(1):103-11; discussion 111-2
references: 16314031
references: BJU Int. 2004 Jul;94(2):244-50
references: 15217417
references: J Urol. 1992 Aug;148(2 Pt 1):331-7
references: 1635129
references: BJU Int. 2004 Jul;94(2):238-43
references: 15217416
references: Eur Urol. 2006 May;49(5):859-65
references: 16519991
references: J Urol. 2006 Dec;176(6 Pt 1):2459-63; discussion 2463
references: 17085129
references: Eur Urol. 2011 Sep;60(3):413-9
references: 21612859
references: Eur Urol. 2010 Nov;58(5):781-7
references: 20691531
references: Ann Surg. 2004 Aug;240(2):205-13
references: 15273542
references: Urology. 2008 Sep;72(3):593-7
references: 18762050
references: Eur Urol. 2006 Jul;50(1):98-104
references: 16563608
references: J Urol. 2007 Aug;178(2):483-7; discussion 487
references: 17561162
references: Eur Urol. 2008 Jun;53(6):1180-5
references: 17659829
references: Int J Impot Res. 2002 Aug;14(4):245-50
references: 12152112
references: Eur Urol. 1992;21(4):269-73
references: 1459147
references: Eur Urol. 2006 Nov;50(5):969-79; discussion 980
references: 16469429
references: Urology. 2009 Apr;73(4):856-9
references: 19022487
references: BJU Int. 2009 Sep;104(5):611-5
references: 19298408
references: Urology. 2009 Mar;73(3):577-81
references: 19100598
references: Eur Urol. 2008 Jan;53(1):68-80
references: 17920184
references: Eur Urol. 1988;15(3-4):180-1
references: 3215250