Retzius sparing technique leads to improved early continence recovery and better quality of life after robot-assisted radical prostatectomy: a multi-centre series of over 400 men
BAUS ePoster online library. Tan W. 11/10/20; 304149; P10-7
Dr. Wei Shen Tan
Dr. Wei Shen Tan
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Abstract
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Retzius sparing technique leads to improved early continence recovery and better quality of life after robot-assisted radical prostatectomy: a multi-centre series of over 400 men

Tan W1, Eden D2, Eden C3, Cahill D4, Sooriakumaran P1
1University College London, UK, 2Carbit Health, London, UK, 3Royal Surrey County Hospital, UK, 4Royal Marsden Hospital, London, UK

Introduction:
We report patient-reported outcome measures for quality of life (QoL), erectile function and urinary function of patients treated with Retzius sparing robotic assisted radical prostatectomy (RS-RARP) and non-RS-RARP at 9 months.

Methods:
From August 2017- July 2019, 413 patients underwent RARP by three surgeons. Patient demographics, cancer specific variables (PSA, disease risk, pT stage, positive surgical margin [PSM]) and surgical technique were recorded. Patients prospectively completed EQ-5D-3L, IIEF-5 and mLUTS questionnaires 7days prior to surgery and postoperatively at 7days, 1,3,6 and 9 months. The practice management software Carebit was used.

Results:
A total of 240 and 173 patients had a non-RS-RARP and RS-RARP respectively. There was no difference in PSM (RS-RARP: 21.4% vs non-RS-RARP: 17.1%, p>0.1). Baseline EQ-5D-3L, IIEF and mLUTS between both patient cohorts were similar (all p>0.1). RS-RARP patients reported significantly better EQ-5D-3L scores compared to non-RS-RARP (81vs76, p=0.026) at 7days but there was no difference at 1,3,6 and 9 months follow-up (all >0.1). No difference in IIEF scores between the two cohorts at 1,3,6 and 9months (all >0.1) were observed. RS-RARP patients has a lower mLUTS score at 1month (20vs31, p<0.01). mLUTS scores remained lower for RS-RARP patients at 3 (17vs21, p>0.1), 6 (14vs20, p=>0.1), 9 (14vs15, p>0.1) and 12months (11vs17, p=0.09).

Conclusion:
We report better immediate QoL and urinary function including continence recovery in patients treated with RS-RARP. RS-RARP did not result in worse early oncological results and thus the trade-off between cancer control and functional outcomes appears to favour RS-RARP over non-RS-RARP.
Retzius sparing technique leads to improved early continence recovery and better quality of life after robot-assisted radical prostatectomy: a multi-centre series of over 400 men

Tan W1, Eden D2, Eden C3, Cahill D4, Sooriakumaran P1
1University College London, UK, 2Carbit Health, London, UK, 3Royal Surrey County Hospital, UK, 4Royal Marsden Hospital, London, UK

Introduction:
We report patient-reported outcome measures for quality of life (QoL), erectile function and urinary function of patients treated with Retzius sparing robotic assisted radical prostatectomy (RS-RARP) and non-RS-RARP at 9 months.

Methods:
From August 2017- July 2019, 413 patients underwent RARP by three surgeons. Patient demographics, cancer specific variables (PSA, disease risk, pT stage, positive surgical margin [PSM]) and surgical technique were recorded. Patients prospectively completed EQ-5D-3L, IIEF-5 and mLUTS questionnaires 7days prior to surgery and postoperatively at 7days, 1,3,6 and 9 months. The practice management software Carebit was used.

Results:
A total of 240 and 173 patients had a non-RS-RARP and RS-RARP respectively. There was no difference in PSM (RS-RARP: 21.4% vs non-RS-RARP: 17.1%, p>0.1). Baseline EQ-5D-3L, IIEF and mLUTS between both patient cohorts were similar (all p>0.1). RS-RARP patients reported significantly better EQ-5D-3L scores compared to non-RS-RARP (81vs76, p=0.026) at 7days but there was no difference at 1,3,6 and 9 months follow-up (all >0.1). No difference in IIEF scores between the two cohorts at 1,3,6 and 9months (all >0.1) were observed. RS-RARP patients has a lower mLUTS score at 1month (20vs31, p<0.01). mLUTS scores remained lower for RS-RARP patients at 3 (17vs21, p>0.1), 6 (14vs20, p=>0.1), 9 (14vs15, p>0.1) and 12months (11vs17, p=0.09).

Conclusion:
We report better immediate QoL and urinary function including continence recovery in patients treated with RS-RARP. RS-RARP did not result in worse early oncological results and thus the trade-off between cancer control and functional outcomes appears to favour RS-RARP over non-RS-RARP.
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