UP-148 Age-stratified potency outcomes of bilateral nerve sparing robotic-assisted radical prostatectomy
Thursday June 27, 2019 from

Adel Arezki, Canada

Medical Student

McGill Medicine



Age-stratified potency outcomes of bilateral nerve sparing robotic-assisted radical prostatectomy

Adel Arezki1, Iman Sadri1, Ahmed S. Zakaria2, Félix Couture3, David-Dan Nguyen1, Pierre Karakiewicz2, Dean S. Elterman4, Ali Abdullah2, Kevin C. Zorn2.

1Faculty of Medicine, McGill University, Montreal, QC, Canada; 2Division of Urology, Department of Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada; 3Division of Urology, Centre Hospitalier Universitaire de Sherbrooke, Montreal, QC, Canada; 4Division of Urology, University Health Network, University of Toronto, Toronto, QC, Canada

Introduction: This study aims to report age-stratified potency outcomes in Canadian men undergoing robot-assisted radical prostatectomy (RARP). 

Methods: A retrospective review was performed on a database of 1737 patients who underwent RARP for localized prostate cancer between 2007 and 2019. Inclusion criteria consisted of patients undergoing bilateral nerve-sparing RARP. Exclusion criteria were preoperative Sexual Health Inventory for Men (SHIM) score <17 and post-operative androgen deprivation therapy or radiotherapy. Patients were divided into four cohorts based on age: ≤ 54 years (group 1);  55-59 years (group 2); 60-64 years (group 3) and ≥65 years (group 4). Functional outcomes were measured up to 36 months. Kaplan–Meier analysis was performed to compare the time to recovery of potency stratified by age groups using log-rank testing. 

Results: 542 patients met the selection criteria. Potency rates were significantly different between groups. Groups 1 through 4 demonstrated potency recovery rates of 64.2%, 52.3%, 36.6% and 20.7% at one-year follow-up, respectively. After 3 years, groups 1 through 4 had potency rates of 77.9%, 67.0%, 50.5% and 35.0%, respectively.   Recovery of potency was achieved at a median time after surgery of 199, 340 and 853 days for groups 1-3, respectively. The Cox proportional hazard model showed that older age, higher BMI, and lower preoperative SHIM score were associated with significantly higher rates of impotence. 

Conclusion: This study shows that RARP has acceptable potency outcomes, regardless of age. However, patient factors, including older age and pre-operative SHIM were significantly associated with poorer functional recovery. This data is valuable in prognostic evaluation and patient counselling.

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