The value of periprostatic fascia thickness and fascia preservation as prognostic factors of erectile function after nerve-sparing robot-assisted radical prostatectomy

2018 ◽  
Vol 37 (2) ◽  
pp. 309-315
Author(s):  
Nikolaos Grivas ◽  
Rosanne C. van der Roest ◽  
Clarize M. de Korne ◽  
Gijs H. KleinJan ◽  
Karolina Sikorska ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Radical Prostatectomy ◽  
Erectile Function ◽  
Nerve Sparing ◽  
Robot Assisted

scholarly journals Immediate post-operative PDE5i Therapy improves early Erectile Function Outcomes after Robot Assisted Radical Prostatectomy (RARP)

2020 ◽  
Author(s):  
Arjun Nathan ◽  
Shivani Shukla ◽  
Amil Sinha ◽  
Sailantra Sivathasan ◽  
Amir Rashid ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Erectile Function ◽  
Phosphodiesterase Inhibitor ◽  
Nerve Sparing ◽  
Robot Assisted ◽  
Readmission Rates ◽  
Early Therapy ◽  
Tertiary Centre ◽  
Unilateral Group

Objectives To assess whether the timing of post-operative Phosphodiesterase Inhibitor (PDE5i) therapy after Robot Assisted Radical Prostatectomy (RARP) is associated with a change in early erectile function outcomes. Additionally, to determine whether there are differences in continence or safety outcomes. Subjects/patients and methods Data was prospectively collected from a single surgeon in one tertiary centre and retrospectively evaluated. 158 patients were treated with PDE5i therapy post RARP over a two-year period. PDE5i therapy was started: immediately (day 1-2) post-op in 29%, early (day 3-14) post-op in 37% and late (after day 14) post-op in 34%. EPIC-26 Erectile Function (EF) scores were collected pre-op and post-op with a median follow-up time of 43 days. Results The median age was 64 and the median BMI was 27. 9% of the series had Charlson Co-Morbidities. There were no significant differences in pre-operative characteristics between the therapy groups. Patients that had bilateral nerve sparing had a mean drop in Erectile Function (EF) score by 5.4 compared to 8.8 in the unilateral group. Additionally, 34.9% of bilateral nerve sparing patients returned to baseline compared to 12.1% of unilateral. Drop in EF scores and percentage return to baseline for unilateral nerve sparing was respectively 9 and 11.1% of immediate therapy, 7 and 14.8% of early therapy and 9.7 and 9.5% of late therapy (p=0.9 and p=0.6). For bilateral nerve sparing this was respectively 3.5 and 42.9% immediate therapy, 5.5 and 35.5% early therapy and 7.3 and 25% late therapy (p=0.017 and p=0.045). Pad free and social continence was achieved in 54% and 37% of those receiving immediate therapy, 60% and 33% for early therapy and 26% and 54% for late therapy. There were no differences in compliance, complication or readmission outcomes. Conclusion In patients with bilateral nerve sparing RARP, immediate post-operative PDE5i therapy may protect EF. Early onset (3-14 days) may also provide a benefit compared to initiating PDE5i therapy later (after 14 days). Expediting therapy for patients undergoing unilateral nerve sparing may also provide a benefit; however, the differences are less pronounced. Immediate or early PDE5i therapy also improved early continence outcomes for patients with bilateral nerve sparing, compared to late therapy. There were no differences in compliance, complication or readmission rates between the groups. Therefore, immediate PDE5i therapy should be considered in patients following nerve sparing RARP in order to maximise functional outcomes, especially in those undergoing bilateral nerve spare.

Does topical hemostatic agent (Floseal®) have a long-term adverse effect on erectile function recovery after nerve-sparing robot-assisted radical prostatectomy?

2017 ◽  
Vol 49 (9) ◽  
pp. 1519-1526 ◽  
Author(s):  
Eugenio Martorana ◽  
Bernardo Rocco ◽  
Shaniko Kaleci ◽  
Giacomo Maria Pirola ◽  
Luigi Bevilacqua ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Radical Prostatectomy ◽  
Erectile Function ◽  
Hemostatic Agent ◽  
Nerve Sparing ◽  
Robot Assisted ◽  
Term Adverse Effect ◽  
Function Recovery

Does Surgeon Subjective Nerve Sparing Score Predict Recovery Time of Erectile Function Following Robot-Assisted Radical Prostatectomy?

2015 ◽  
Vol 12 (6) ◽  
pp. 1490-1496 ◽  
Author(s):  
Sung Gu Kang ◽  
Oscar Schatloff ◽  
Abdul Muhsin Haidar ◽  
Srinivas Samavedi ◽  
Kenneth J. Palmer ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Erectile Function ◽  
Recovery Time ◽  
Nerve Sparing ◽  
Robot Assisted

scholarly journals 31 Immediate Post-Operative Phosphodiesterase-5 Inhibitors (PDE5i) Therapy Improves Early Erectile Function Outcomes After Robot Assisted Radical Prostatectomy (RARP)

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Nathan ◽  
S Shukla ◽  
A Sinha ◽  
S Sivathasan ◽  
A Rashid ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Erectile Function ◽  
Nerve Sparing ◽  
Robot Assisted ◽  
Phosphodiesterase 5 Inhibitors ◽  
Tertiary Centre ◽  
Safety Outcomes ◽  
Phosphodiesterase 5

Abstract Introduction To assess whether the timing of post-RARP PDE5i therapy affects early erectile function, continence, or safety outcomes. Method Data from 158 patients treated with PDE5is post-RARP was prospectively collected over two years from a single surgeon at one tertiary centre and retrospectively evaluated. Therapy was started: immediately (day 1-2) in 29%, early (day 3-14) in 37% and late (after day 14) post-op in 34%. EPIC-26 Erectile Function (EF) scores were collected pre-op and post-op after a median 43-day follow-up interval. Results Drop in EF scores and percentage return to baseline post unilateral nerve sparing (UNS) compared to bilateral nerve sparing (BNS) RARP was respectively 9 and 11.1% versus 3.5 and 42.9% of immediate therapy, 7 and 14.8% versus 5.5 and 35.5% of early and 9.7 and 9.5% versus 7.3 and 25% of late. Pad free and social continence was achieved in 54% and 37% of those receiving immediate therapy, 60% and 33% for early and 26% and 54% for late. Conclusions Immediate post RARP PDE5i therapy may protect EF and should be considered clinically, with more benefits for BNS than UNS patients. Immediate or early, rather than late, PDE5i therapy improved early continence in BNS patients.

scholarly journals 198 Immediate Post-Operative PDE5i Therapy Improves Early Erectile Function Outcomes after Robot-Assisted Radical Prostatectomy (RARP)

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Nathan ◽  
A Rashid ◽  
S Shukla ◽  
A Sinha ◽  
S Sivathasan ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Erectile Function ◽  
Functional Outcomes ◽  
Phosphodiesterase Inhibitor ◽  
Nerve Sparing ◽  
Robot Assisted ◽  
Early Therapy ◽  
Tertiary Centre ◽  
Unilateral Group ◽  
Nerve Spare

Abstract Aim To assess whether the timing of post-operative Phosphodiesterase Inhibitor (PDE5i) therapy after Robot Assisted Radical Prostatectomy (RARP) is associated with a change in early erectile function, continence, or safety outcomes. Method Data was prospectively collected from a single surgeon in one tertiary centre and retrospectively evaluated. 158 patients were treated with PDE5i therapy post RARP over a two-year period. Results There were no significant differences in pre-operative characteristics between the therapy groups. Patients that had bilateral nerve sparing had a mean drop in Erectile Function (EF) score by 5.4 compared to 8.8 in the unilateral group. Additionally, 34.9% of bilateral nerve sparing patients returned to baseline compared to 12.1% of unilateral. Drop in EF scores and percentage return to baseline for unilateral nerve sparing was respectively 9 and 11.1% of immediate (day 1-2), 7 and 14.8% of early (day 3-14) and 9.7 and 9.5% of late (day >14) therapy (p = 0.9 and p = 0.6). For bilateral nerve sparing this was respectively 3.5 and 42.9% immediate therapy, 5.5 and 35.5% early therapy and 7.3 and 25% late therapy (p = 0.017 and p = 0.045). Pad free and social continence was achieved in 54% and 37% of those receiving immediate therapy, 60% and 33% for early therapy and 26% and 54% for late therapy. There were no differences in compliance, complication, or readmission outcomes. Conclusions Immediate PDE5i therapy should be considered in patients following nerve sparing RARP in order to maximise functional outcomes, especially in those undergoing bilateral nerve spare.

scholarly journals Impact of Sarcopenia on Erectile Function after Nerve-Sparing Robot-Assisted Radical Prostatectomy

2020 ◽  
Vol 38 ◽  
Author(s):  
Yosuke Mitsui ◽  
Takuya Sadahira ◽  
Yuki Maruyama ◽  
Ryota Sato ◽  
Acosta Gonzalez Herik Rodrigo ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Erectile Function ◽  
Nerve Sparing ◽  
Robot Assisted

scholarly journals Immediate post-operative PDE5i therapy improves early erectile function outcomes after robot assisted radical prostatectomy (RARP)

2021 ◽  
Author(s):  
Arjun Nathan ◽  
Shivani Shukla ◽  
Amil Sinha ◽  
Sailantra Sivathasan ◽  
Amir Rashid ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Erectile Function ◽  
Functional Outcomes ◽  
Phosphodiesterase Inhibitor ◽  
Nerve Sparing ◽  
Robot Assisted ◽  
Early Therapy ◽  
Tertiary Centre ◽  
Safety Outcomes

AbstractTo assess whether the timing of post-operative Phosphodiesterase Inhibitor (PDE5i) therapy after Robot-Assisted Radical Prostatectomy (RARP) is associated with a change in early erectile function (EF) outcomes, continence or safety outcomes. Data were prospectively collected from a single surgeon in one tertiary centre. 158 patients were treated with PDE5i therapy post RARP over a 2-year period. PDE5i therapy was started: immediately (day 1–2) post-op in 29%, early (day 3–14) post-op in 37% and late (after day 14) post-op in 34%. EPIC-26 EF scores were collected pre-op and post-op. There were no significant differences in pre-operative characteristics between the therapy groups. Drop in EF scores and percentage return to baseline for unilateral nerve sparing was, respectively, 9 and 11.1% of immediate therapy, 7 and 14.8% of early therapy and 9.7 and 9.5% of late therapy (p = 0.9 and p = 0.6). For bilateral nerve sparing, this was, respectively, 3.5 and 42.9% immediate therapy, 5.5 and 35.5% early therapy and 7.3 and 25% late therapy (p = 0.017 and p = 0.045). Pad free and social continence were achieved in 54% and 37% of those receiving immediate therapy, 60% and 33% for early therapy and 26% and 54% for late therapy. There were no differences in compliance, complication or readmission outcomes. In patients with bilateral nerve sparing RARP, immediate post-operative PDE5i therapy can protect EF and improve early continence outcomes. Therefore, immediate PDE5i therapy should be considered in patients following nerve sparing RARP to maximise functional outcomes.

1172: Improved Recovery of Erectile Function with Nightly Low dose Sildenafil - 18 Months Follow-Up After Nerve-Sparing Radical Prostatectomy

2007 ◽  
Vol 177 (4S) ◽  
pp. 386-387
Author(s):  
Andreas Bannowsky ◽  
Heiko Schulze ◽  
Christof van der Horst ◽  
Stefan Hautmann ◽  
Klaus P. Juenemann
Keyword(s):  
Radical Prostatectomy ◽  
Erectile Function ◽  
Low Dose ◽  
Nerve Sparing
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