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Width of spared neurovascular bundle after robot-assisted laparoscopic prostatectomy in patients with prostate cancer: is it a Ched reliable factor for predicting postoperative sexual outcome?

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Abstract
Purpose: To investigate the relationship between the width of spared neurovascular bundle (NVB) measured during robot-assisted laparoscopic prostatectomy and postoperative sexual outcomes.

Methods: Patients with localized prostate cancer with erectile hardness score >= 2 (N = 105) who underwent NVB-sparing robot-assisted laparoscopic prostatectomy were included. Patients were divided into three groups [first (Q1) vs. second and third (Q2-3) vs. fourth (Q4) quartile] according to width of spared NVB measured with a flexible ruler after prostate removal. Preoperative and postoperative sexual function was evaluated according to erectile hardness score and Expanded Prostate Cancer Index Composite questionnaires.

Results: The proportion of patients with postoperative erectile hardness score >= 2 at postoperative 6 months was as follows: 38.9% (Q1), 48.6% (Q2-3), and 83.3% (Q4) (P = 0.016). The preoperative/postoperative 6-month sexual function score was 40.7/16.9 (Q1), 48.1/19.0 (Q2-3), and 51.2/28.1 (Q4). Postoperative sexual function was significantly associated with preoperative sexual function in Q4 (P = 0.006) and Q2-3 (P = 0.030) but not in Ql. On multivariate analysis, the width of spared NVB was a significant predictor for postoperative 6-month erectile hardness score >= 2. Limitation includes selection bias and short follow-up duration.

Conclusions: Not only the performance but also the degree and quality of NVB sparing thought to be important for postoperative sexual function. Measurement of the width of NVB during surgery could be an easy intraoperative method for assessing the quality of NVB sparing. (C) 2021 Asian Pacific Prostate Society. Publishing services by Elsevier B.V.
Author(s)
유상준임범진최세영유달산김청수
Issued Date
2021
Type
Article
Keyword
Erectile dysfunctionNerve tissueProstatic neoplasmsProstatectomy
DOI
10.1016/j.prnil.2020.07.005
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7487
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_860221a296884d1f97f8f66f927124d8&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Width%20of%20spared%20neurovascular%20bundle%20after%20robot-assisted%20laparoscopic%20prostatectomy%20in%20patients%20with%20prostate%20cancer:%20is%20it%20a%20Ched%20reliable%20factor%20for%20predicting%20postoperative%20sexual%20outcome%3F&offset=0&pcAvailability=true
Publisher
PROSTATE INTERNATIONAL
Location
미국
Language
영어
ISSN
2287-8882
Citation Volume
9
Citation Number
3
Citation Start Page
119
Citation End Page
124
Appears in Collections:
Medicine > Medicine
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