Background: The best technique of radical prostatectomy – open retropubic versus robot-assisted surgery – is a subject of controversy. Patients and Methods: Between January 1st, 2007 and December 31st, 2011, 2,177 men underwent radical prostatectomy at our department. 252 (12%) cases were laparoscopic robot-assisted, the remainder open retropubic procedures. In Germany, certified prostate cancer centers are required to collect urinary tract-related outcome data after radical prostatectomy using the International Consultation of Incontinence Questionnaire Male Lower Urinary Tract Symptoms. The questionnaire data were used to compare both surgical approaches concerning the urinary tract-related outcome 1, 2 and 3 years postoperatively. Results: Neither the voiding score nor the incontinence score or the bother scale sum differed between the two cohorts at any of the measurement times. Conclusions: Concerning continence recovery, in this series, there were no detectable differences between robot-assisted and open radical prostatectomy.

Keywords:
Health service research, Quality of life, Continence, Radical prostatectomy, Open retropubic surgery, Robot-assisted surgery, ICIQ-MLUTS
1.
Heidenreich A, Bastian PJ, Bellmunt J, Bolla M, Joniau S, Mason MD, Matveev V, Mottet N, van der Kwast TH, Wiegel T, Zattoni F: EAU guidelines on prostate cancer. Update 2012. http://www.uroweb.org/gls/pdf/08%20Prostate%20Cancer_LR%20March%2013th%202012.pdf; accessed October 10, 2012.
2.
Moreno Sierra J, Fernández Pérez C, Ortiz Oshiro E, Silmi Moyano A, Villavicencio Mavrich H, Pereira Arias JG, Allona Almagro A, Unda Urzaiz M, Padilla Nieva J, Madina Albisua I, Estebanez Zarranz J, Medina López R, Baena Gonzalez V, Franco Miranda E, Morote Robles J, Gomez Ruiz JJ: Key areas in the learning curve for robotic urological surgery: a Spanish multicentre survey. Urol Int 2011;87:64–69.
3.
Shigemura K, Yamanaka N, Yamashita M: Veil nerve-sparing technique and postoperative urinary continence in open antegrade radical prostatectomy. Urol Int 2012;89:283–289.
4.
Abrams P, Avery K, Gardener N, Donovan J, ICIQ Advisory Board: The International Consultation on Incontinence Modular Questionnaire: www.iciq.net. J Urol 2006;175:1063–1066.
5.
Ficarra V, Novara G, Rosen RC, Artibani W, Carroll PR, Costello A, Menon M, Montorsi F, Patel VR, Stolzenburg JU, Van der Poel H, Wilson TG, Zattoni F, Mottrie A: Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. Eur Urol 2012;62:405–417.
6.
Ho C, Tsakonas E, Tran K, Cimon K, Severn M, Mierzwinski-Urban M, Corcos J, Pautler S: Robot-assisted surgery compared with open surgery and laparoscopic surgery: clinical effectiveness and economic analyses (Technology report No 137). Ottawa, Canadian Agency for Drugs and Technologies in Health, 2011. http://www.cadth.ca/en/products/health-technology-assessment/publication/2682; accessed October 10, 2012.
7.
Kim SC, Song C, Kim W, Kang T, Park J, Jeong IG, Lee S, Cho YM, Ahn H: Factors determining functional outcomes after radical prostatectomy: robot-assisted versus retropubic. Eur Urol 2011;60:413–419.
8.
Rocco B, Matei DV, Melegari S, Ospina JC, Mazzoleni F, Errico G, Mastropasqua M, Santoro L, Detti S, de Cobelli O: Robotic vs open prostatectomy in a laparoscopically naive centre: a matched-pair analysis. BJU Int 2009;104:991–995.
9.
Ficarra V, Novara G, Fracalanza S, D’Elia C, Secco S, Iafrate M, Cavalleri S, Artibani W: A prospective, non-randomized trial comparing robot-assisted laparoscopic and retropubic radical prostatectomy in one European institution. BJU Int 2009;104:534–539.
10.
Minniti D, Chiadò Piat S, Di Novi C: Robot-assisted versus open radical prostatectomy: an evidence-based comparison. Technol Health Care 2011;19:331–339.
11.
Doumerc N, Yuen C, Savdie R, Rahman MB, Rasiah KK, Pe Benito R, Delprado W, Matthews J, Haynes AM, Stricker PD: Should experienced open prostatic surgeons convert to robotic surgery? The real learning curve for one surgeon over 3 years. BJU Int 2010;106:378–384.
12.
Wirth MP, Froehner M: Robot-assisted radical prostatectomy: the new gold standard? Eur Urol 2010;57:750–751.
13.
Wirth MP, Froehner M: Radical prostatectomy-only centers: the future in genitourinary surgery? Eur Urol 2010;57:953–954.
14.
Barry MJ, Gallagher PM, Skinner JS, Fowler FJ Jr: Adverse effects of robotic-assisted laparoscopic versus open retropubic radical prostatectomy among a nationwide random sample of medicare-age men. J Clin Oncol 2012;30:513–518.
15.
Hu JC, Gu X, Lipsitz SR, Barry MJ, D’Amico AV, Weinberg AC, Keating NL: Comparative effectiveness of minimally invasive vs open radical prostatectomy. JAMA 2009;302:1557–1564.
© 2012 S. Karger AG, Basel
2012
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.