Potency, continence and complications in 3,477 consecutive radical retropubic prostatectomies

Shilajit D Kundu, Kimberly A. Roehl, Scott E. Eggener, Jo Ann V. Antenor, Misop Han, William J Catalona*

*Corresponding author for this work

Research output: Contribution to journalArticle

447 Citations (Scopus)

Abstract

Purpose: We report results in a series of 3,477 consecutive patients treated with anatomical nerve sparing radical retropubic prostatectomy (RRP) in terms of recovery of erectile function, urinary continence and postoperative complications. Materials and Methods: From May 1983 through February 2003, 1 surgeon (WJC) performed anatomical RRP using a unilateral or bilateral nerve sparing modification when possible. Urinary continence and recovery of erections were evaluated in men with a minimum followup of 18 months. Excluded from potency analysis were men who were not reliably potent before surgery, those who did not undergo a nerve sparing procedure and those who received postoperative adjuvant radiotherapy or hormonal therapy within 18 months of surgery. Other postoperative complications in this patient population were also evaluated. Results: Erections sufficient for intercourse occurred in 76% of preoperatively potent men treated with bilateral (1,770) and 53% of men treated with unilateral or partial nerve sparing (64) surgery. Adequate erectile function was more common following bilateral than unilateral nerve sparing surgery in men younger than 70 years old (78% versus 53%, p = 0.001) compared with those 70 years old or older (52% versus 56%, p = 0.6). Recovery of urinary continence occurred in 93% of all men and was associated with younger age (p = 0.001) but not nerve sparing surgery, tumor stage, prostate specific antigen (PSA), Gleason grade or number of prior prostatectomies performed by the surgeon. Postoperative complications occurred in 320 (9%) of patients and were associated with older age (p <0.0001), nonnerve sparing surgery (p = 0.001), PSA era (p <0.0001) and surgeon experience. Complications were not significantly correlated with clinical stage, pathological stage, preoperative PSA or Gleason grade. There was no perioperative mortality. Conclusions: Nerve sparing RRP can be performed with favorable potency and urinary continence. Better results are achieved in younger men. Other complications are reduced with increasing surgeon experience.

Original languageEnglish (US)
Pages (from-to)2227-2231
Number of pages5
JournalJournal of Urology
Volume172
Issue number6 I
DOIs
StatePublished - Jan 1 2004

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Prostatectomy
Prostate-Specific Antigen
Adjuvant Radiotherapy
Recovery of Function
Mortality
Surgeons
Population
Neoplasms

Keywords

  • Penile erection
  • Prostatectomy
  • Prostatic neoplasms
  • Urinary incontinence

ASJC Scopus subject areas

  • Urology

Cite this

Kundu, Shilajit D ; Roehl, Kimberly A. ; Eggener, Scott E. ; Antenor, Jo Ann V. ; Han, Misop ; Catalona, William J. / Potency, continence and complications in 3,477 consecutive radical retropubic prostatectomies. In: Journal of Urology. 2004 ; Vol. 172, No. 6 I. pp. 2227-2231.
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abstract = "Purpose: We report results in a series of 3,477 consecutive patients treated with anatomical nerve sparing radical retropubic prostatectomy (RRP) in terms of recovery of erectile function, urinary continence and postoperative complications. Materials and Methods: From May 1983 through February 2003, 1 surgeon (WJC) performed anatomical RRP using a unilateral or bilateral nerve sparing modification when possible. Urinary continence and recovery of erections were evaluated in men with a minimum followup of 18 months. Excluded from potency analysis were men who were not reliably potent before surgery, those who did not undergo a nerve sparing procedure and those who received postoperative adjuvant radiotherapy or hormonal therapy within 18 months of surgery. Other postoperative complications in this patient population were also evaluated. Results: Erections sufficient for intercourse occurred in 76{\%} of preoperatively potent men treated with bilateral (1,770) and 53{\%} of men treated with unilateral or partial nerve sparing (64) surgery. Adequate erectile function was more common following bilateral than unilateral nerve sparing surgery in men younger than 70 years old (78{\%} versus 53{\%}, p = 0.001) compared with those 70 years old or older (52{\%} versus 56{\%}, p = 0.6). Recovery of urinary continence occurred in 93{\%} of all men and was associated with younger age (p = 0.001) but not nerve sparing surgery, tumor stage, prostate specific antigen (PSA), Gleason grade or number of prior prostatectomies performed by the surgeon. Postoperative complications occurred in 320 (9{\%}) of patients and were associated with older age (p <0.0001), nonnerve sparing surgery (p = 0.001), PSA era (p <0.0001) and surgeon experience. Complications were not significantly correlated with clinical stage, pathological stage, preoperative PSA or Gleason grade. There was no perioperative mortality. Conclusions: Nerve sparing RRP can be performed with favorable potency and urinary continence. Better results are achieved in younger men. Other complications are reduced with increasing surgeon experience.",
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Potency, continence and complications in 3,477 consecutive radical retropubic prostatectomies. / Kundu, Shilajit D; Roehl, Kimberly A.; Eggener, Scott E.; Antenor, Jo Ann V.; Han, Misop; Catalona, William J.

In: Journal of Urology, Vol. 172, No. 6 I, 01.01.2004, p. 2227-2231.

Research output: Contribution to journalArticle

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T1 - Potency, continence and complications in 3,477 consecutive radical retropubic prostatectomies

AU - Kundu, Shilajit D

AU - Roehl, Kimberly A.

AU - Eggener, Scott E.

AU - Antenor, Jo Ann V.

AU - Han, Misop

AU - Catalona, William J

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N2 - Purpose: We report results in a series of 3,477 consecutive patients treated with anatomical nerve sparing radical retropubic prostatectomy (RRP) in terms of recovery of erectile function, urinary continence and postoperative complications. Materials and Methods: From May 1983 through February 2003, 1 surgeon (WJC) performed anatomical RRP using a unilateral or bilateral nerve sparing modification when possible. Urinary continence and recovery of erections were evaluated in men with a minimum followup of 18 months. Excluded from potency analysis were men who were not reliably potent before surgery, those who did not undergo a nerve sparing procedure and those who received postoperative adjuvant radiotherapy or hormonal therapy within 18 months of surgery. Other postoperative complications in this patient population were also evaluated. Results: Erections sufficient for intercourse occurred in 76% of preoperatively potent men treated with bilateral (1,770) and 53% of men treated with unilateral or partial nerve sparing (64) surgery. Adequate erectile function was more common following bilateral than unilateral nerve sparing surgery in men younger than 70 years old (78% versus 53%, p = 0.001) compared with those 70 years old or older (52% versus 56%, p = 0.6). Recovery of urinary continence occurred in 93% of all men and was associated with younger age (p = 0.001) but not nerve sparing surgery, tumor stage, prostate specific antigen (PSA), Gleason grade or number of prior prostatectomies performed by the surgeon. Postoperative complications occurred in 320 (9%) of patients and were associated with older age (p <0.0001), nonnerve sparing surgery (p = 0.001), PSA era (p <0.0001) and surgeon experience. Complications were not significantly correlated with clinical stage, pathological stage, preoperative PSA or Gleason grade. There was no perioperative mortality. Conclusions: Nerve sparing RRP can be performed with favorable potency and urinary continence. Better results are achieved in younger men. Other complications are reduced with increasing surgeon experience.

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KW - Penile erection

KW - Prostatectomy

KW - Prostatic neoplasms

KW - Urinary incontinence

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