Comparison of Urinary Continence Outcome between
Robotic Assisted Laparoscopic Prostatectomy versus
Laparoscopic Radical Prostatectomy
Kittipak Asawabharuj MD*, Patkawat Ramart MD*, Chaiyong Nualyong MD*,
Sunai Leewansangtong MD*, Sittiporn Srinualnad MD*, Tawatchai Taweemonkongsap MD*,
Bansithi Chaiyaprasithi MD*, Teerapon Amornvesukit MD*, Siros Jitpraphai MD*, Suchai Soontrapa MD*
Affiliation :
* Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To compare urinary continent rate at six and 12-month postoperative period, and perioperative outcome between
robotic-assisted laparoscopic radical prostatectomy (RALP) and laparoscopic radical prostatectomy (LRP) at Siriraj
Hospital.
Material and Method: All medical records of patients performed RALP and LRP between 2005 and 2010 were reviewed.
Data composed of demographic information, perioperative outcome, and oncologic outcome. Moreover, the urinary
continence rate was also collected at six and 12-month postoperative period by questionnaires based research design.
Results : Between 2005 and 2010, we performed 548 cases of RALP and 613 cases of LRP. Only 486 cases of RALP (88.6%)
and 561 cases of LRP (91.5%) had been followed-up more than 12 months. All demographic data including age, biopsy
Gleason score, and preoperative PSA level in both groups were comparably. On the other hand, the perioperative outcome
in RALP differed from LRP group significantly, including operative time (210 min vs. 255 min), blood loss (449 ml vs.
766 ml), blood transfusion rate (7.6% vs. 25.2%), and length of hospital stay (7 days vs. 8.6 days) (p<0.001). The oncological
outcome including pathologic tumor staging and Gleason score were comparably. Late complication such as anastamosis
stricture was not different between the two groups (3.1% in RALP vs. 2.4% in LRP, p = 0.584).
The continence rate of RALP and LRP groups at 6-month was 67.8% and 39% and at 12-month was 80% and
63.7%, respectively. The continence rate of RALP was better than LRP significantly.
Conclusion : From our experience, perioperative outcome and continence rate at six and 12-month of RALP group was
significantly better than LRP group. The demographic data, oncological outcome, and anastamosis stricture rate were
comparably in both groups. The most relevant preoperative predictors of urinary continence were patient’s age and prostatic
weight.
Keywords : Laparoscopic radical prostatectomy (LRP), Robotic-assisted laparoscopic prostatectomy (RALP), Outcome,
Continence
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