Background and Purpose: Treatment of prostate cancer has evolved considerably in the last decade, especially in terms of minimisation of the negative impacts on erectile function and continence to ensure good quality of life for treated patients.
New surgical devices, such as dissectors and haemostatic scalpels, allow precise definition of the surgical field with finer dissection of the anatomic structures, with subsequent reductions in operative times and better oncological and functional outcomes. Although monopolar scissors (MS) are still widely used, radiofrequency (RF) and ultrasound (US) scalpels have been recently introduced in laparoscopic radical prostatectomy (LRP). However, despite the widespread use of these scalpels, few studies have compared these devices in terms of oncological and functional outcomes after radical prostatectomy. The present study aimed to prospectively assess the impact of MS, RF and US scalpels on margin status at apex, and recovery of urinary continence and erectile function in patients undergoing extraperitoneal LRP.
Materials and Methods: A total of 150 men were prospectively enrolled between September 2009 and April 2013 and postoperatively evaluated for continence and clinical factors.
Results: There were no differences in terms of operative times (p= 0.9433), blood loss (p=0.9681), apical margin positivity (p=,0.3965) or postoperative hospital stay (p = 0.9257) between the groups. Moreover, no differences in the functional outcome scores, as evaluated by the International Consultation on Incontinence self-administered Questionnaire, at 1, 3, and 6 months post-surgery were observed.
Conclusion: Our study represents the first evaluation of continence recovery in LRP with respect to different devices used for prostatic apex dissection. We found that the oncological, functional, and operative outcomes were similar between these different devices during LRP, with no scalpel demonstrating superiority in continence recovery.
Written by:
Pastore AL, Palleschi G, Messas A, Fuschi A, Zucchi A, Costantini E, Silvestri L, Petrozza V, Carbone A. Are you the author?
Sapienza University of Rome, Faculty of Pharmacy and Medicine, Medico-Surgical Sciences and Biotechnologies, Urology Unit, ICOT, Latina, Italy.
Reference: J Endourol. 2014 Jun 3. Epub ahead of print.
doi: 10.1089/end.2014.0255
PubMed Abstract
PMID: 24892815
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