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Gu J, Chen H, Gao C, Ren P, Lu X, Cao J. Clinical efficacy of a rehabilitation management protocol for urinary incontinence after robot-assisted laparoscopic prostatectomy. Support Care Cancer 2024; 32:653. [PMID: 39259369 PMCID: PMC11390833 DOI: 10.1007/s00520-024-08846-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Accepted: 08/27/2024] [Indexed: 09/13/2024]
Abstract
OBJECTIVE To evaluate the application of a rehabilitation management protocol for urinary incontinence after robot-assisted laparoscopic prostatectomy (RALP). METHODS We conducted a retrospective cohort study of 114 patients who underwent RALP between August 2021 and November 2021 as the control group and a prospective analysis of 114 patients who underwent RALP between May 2022 and August 2022 as the experimental group. The rehabilitation management protocol focused on preoperative stage, postoperative care, day of catheter removal, 1 month postoperative, 3 months postoperative, 6 months postoperative, and 12 months or more postoperative. RESULTS The 24-h pad test was significantly lower in the experimental group compared with the control group at 2 and 6 months after RALP (both P < 0.01). The scores of the international consultation on incontinence questionnaire-short form (ICIQ-SF) in the experimental group were significantly lower than those in the control group at 1 month after RALP (P < 0.01).The scores of quality of life in the experimental group were significantly higher than those of the control group at 1, 2, and 6 months after RALP (all P < 0.01).The scores of Broome Pelvic Muscle Self-efficacy Scale (BPMSES) were lower than those of the control group at 1, 2, 3, and 6 months after RALP (all P < 0.01). CONCLUSION The application of the rehabilitation management protocol had significant beneficial effects on urinary functions and quality of life in patients with prostate cancer after RALP.
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Affiliation(s)
- Jie Gu
- Department of Urology, Affiliated Changhai Hospital of Naval Medical University, Shanghai, China
| | - Huiying Chen
- Nursing Department, Shanghai Gongli Hospital, Shanghai, China
| | - Chengfei Gao
- Department of Urology, Affiliated Changhai Hospital of Naval Medical University, Shanghai, China
| | - Ping Ren
- Department of Urology, Affiliated Changhai Hospital of Naval Medical University, Shanghai, China
| | - Xiaoying Lu
- Nursing Department, Affiliated Changhai Hospital of Naval Medical University, Shanghai, China.
| | - Jie Cao
- Nursing Department, Affiliated Changhai Hospital of Naval Medical University, Shanghai, China.
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Ma J, Xu W, Chen R, Zhu Y, Wang Y, Cao W, Ju G, Ren J, Ye X, He Q, Chang Y, Ren S. Robotic-assisted versus laparoscopic radical prostatectomy for prostate cancer: the first separate systematic review and meta-analysis of randomised controlled trials and non-randomised studies. Int J Surg 2023; 109:1350-1359. [PMID: 37070788 PMCID: PMC10389430 DOI: 10.1097/js9.0000000000000193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 12/30/2022] [Indexed: 04/19/2023]
Abstract
BACKGROUND Due to the lack of sufficient evidence, it is not clear whether robotic-assisted radical prostatectomy (RARP) or laparoscopic radical prostatectomy (LRP) is better for prostate cancer. The authors conducted this study by separately pooling and analysing randomised controlled trials (RCTs) and non-randomised studies to compare the perioperative, functional, and oncologic outcomes between RARP and LRP. METHODS A systematic literature search was performed in March 2022 using Cochrane Library, Pubmed, Embase, Medline, Web of Science, and China National Knowledge Infrastructure. Two independent reviewers performed literature screening, data extraction and quality assessment according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. Subgroup analysis and sensitivity analysis were performed. RESULTS A total of 46 articles were included, including 4 from 3 RCTs and 42 from non-randomised studies. For RCTs, meta-analysis showed that RARP and LRP were similar in blood loss, catheter indwelling time, overall complication rate, overall positive surgical margin and biochemical recurrence rates, but quantitative synthesis of non-randomised studies showed that RARP was associated with less blood loss [weighted mean difference (WMD)=-71.99, 95% CI -99.37 to -44.61, P <0.001], shorter catheterization duration (WMD=-1.03, 95% CI -1.84 to -0.22, P =0.010), shorter hospital stay (WMD=-0.41, 95% CI -0.68 to -0.13, P =0.004), lower transfusion rate (OR=0.44, 95% CI 0.35-0.56, P <0.001), lower overall complication rate (OR=0.72, 95% CI 0.54-0.96, P =0.020), and lower biochemical recurrence rate (OR=0.78, 95% CI 0.66-0.92, P =0.004), compared with LRP. Both meta-analysis of RCTs and quantitative synthesis of non-randomised studies showed that RARP was associated with improved functional outcomes. From the results of the meta-analysis of RCTs, RARP was higher than LRP in terms of overall continence recovery [odds ratio (OR)=1.60, 95% CI 1.16-2.20, P =0.004), overall erectile function recovery (OR=4.07, 95% CI 2.51-6.60, P <0.001), continence recovery at 1 month (OR=2.14, 95% CI 1.25-3.66, P =0.005), 3 (OR=1.51, 95% CI 1.12-2.02, P =0.006), 6 (OR=2.66, 95% CI 1.31-5.40, P =0.007), and 12 months (OR=3.52, 95% CI 1.36-9.13, P =0.010) postoperatively, and potency recovery at 3 (OR=4.25, 95% CI 1.67-10.82, P =0.002), 6 (OR=3.52, 95% CI 1.31-9.44, P =0.010), and 12 months (OR=3.59, 95% CI 1.78-7.27, P <0.001) postoperatively, which were consistent with the quantitative synthesis of non-randomised studies. When sensitivity analysis was performed, the results remained largely unchanged, but the heterogeneity among studies was greatly reduced. CONCLUSION This study suggests that RARP can improve functional outcomes compared with LRP. Meanwhile, RARP has potential advantages in perioperative and oncologic outcomes.
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Affiliation(s)
| | - Weidong Xu
- Department of Urology, Changzheng Hospital
| | - Rui Chen
- Department of Urology, Changhai Hospital
| | | | - Ye Wang
- Department of Urology, Changhai Hospital
| | - Wanli Cao
- Department of Urology, Changzheng Hospital
| | - Guanqun Ju
- Department of Urology, Changzheng Hospital
| | | | - Xiaofei Ye
- Department of Health Statistics, Naval Medical University, Shanghai, China
| | - Qian He
- Department of Health Statistics, Naval Medical University, Shanghai, China
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Hakozaki K, Takeda T, Yasumizu Y, Tanaka N, Matsumoto K, Morita S, Kosaka T, Mizuno R, Asanuma H, Oya M. Predictors of urinary function recovery after laparoscopic and robot-assisted radical prostatectomy. Int Braz J Urol 2022; 49:50-60. [PMID: 36512455 PMCID: PMC9881801 DOI: 10.1590/s1677-5538.ibju.2022.0362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/10/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Even in the era of laparoscopic radical prostatectomy (LRP) and robot-assisted laparoscopic radical prostatectomy (RALP), we sometimes encounter patients with severe urinary incontinence after surgery. The aim of the present study was to identify predictors of urinary continence recovery among patients with urinary incontinence immediately after surgery (UIIAS). MATERIALS AND METHODS We identified 274 patients with clinically localized prostate cancer who underwent LRP and RALP between 2011 and 2018. UIIAS was defined as a urine loss ratio > 0.15 on the first day of urethral catheter removal. Urinary continence recovery was defined as using ≤ 1 pad/day one year after surgery. In the present study, we evaluated factors affecting urinary function recovery one year after surgery among patients with urinary incontinence immediately after LRP and RALP. RESULTS UIIAS was observed in 191 out of 274 patients (69.7%). A multivariate analysis identified age (<65 years, p = 0.015) as an independent predictor affecting immediate urinary continence. Among 191 incontinent patients, urinary continence one year after surgery improved in 153 (80.1%). A multivariate analysis identified age (<65 years, p = 0.003) and estimated blood loss (≥ 100 mL, p = 0.044) as independent predictors affecting urinary continence recovery one year after surgery. CONCLUSION The present results suggest that younger patients and patients with higher intraoperative blood loss recover urinary continence one year after surgery even if they are incontinent immediately after surgery.
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Affiliation(s)
- Kyohei Hakozaki
- Keio University School of MedicineDepartment of UrologyTokyoJapanDepartment of Urology, Keio University School of Medicine, Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Toshikazu Takeda
- Keio University School of MedicineDepartment of UrologyTokyoJapanDepartment of Urology, Keio University School of Medicine, Shinanomachi, Shinjuku-ku, Tokyo, Japan,Correspondence address: Toshikazu Takeda, MD, PhD Department of Urology, Keio University School of Medicine 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan Fax: +81-3-3225-1985 E-mail:
| | - Yota Yasumizu
- Keio University School of MedicineDepartment of UrologyTokyoJapanDepartment of Urology, Keio University School of Medicine, Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Nobuyuki Tanaka
- Keio University School of MedicineDepartment of UrologyTokyoJapanDepartment of Urology, Keio University School of Medicine, Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Kazuhiro Matsumoto
- Keio University School of MedicineDepartment of UrologyTokyoJapanDepartment of Urology, Keio University School of Medicine, Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Shinya Morita
- Keio University School of MedicineDepartment of UrologyTokyoJapanDepartment of Urology, Keio University School of Medicine, Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Takeo Kosaka
- Keio University School of MedicineDepartment of UrologyTokyoJapanDepartment of Urology, Keio University School of Medicine, Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Ryuichi Mizuno
- Keio University School of MedicineDepartment of UrologyTokyoJapanDepartment of Urology, Keio University School of Medicine, Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Hiroshi Asanuma
- Keio University School of MedicineDepartment of UrologyTokyoJapanDepartment of Urology, Keio University School of Medicine, Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Mototsugu Oya
- Keio University School of MedicineDepartment of UrologyTokyoJapanDepartment of Urology, Keio University School of Medicine, Shinanomachi, Shinjuku-ku, Tokyo, Japan
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Jurys T, Burzynski B, Potyka A, Paradysz A. Post-Radical Prostatectomy Erectile Dysfunction Assessed Using the IIEF-5 Questionnaire - A Systematic Literature Review. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2021; 34:55-64. [PMID: 38595677 PMCID: PMC10903601 DOI: 10.1080/19317611.2021.1936333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/18/2021] [Accepted: 05/22/2021] [Indexed: 04/11/2024]
Abstract
Erectile dysfunction is common postoperative complication after radical prostatectomy. The aim of this study is to evaluate erectile dysfunction among the population of men who have undergone radical prostatectomy. Finally, 21 articles are included in the current qualitative analysis. The results suggest that recovery in potency occurs after 12 months after surgery, and that different adjuvant treatment can be used to accelerate recovery and increase effectiveness. However, conclusions are not derived from all the selected articles, but are rather based on those which present clear numerical scores according to the IIEF-5 questionnaire.
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Affiliation(s)
- Tomasz Jurys
- Doctoral School, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Bartlomiej Burzynski
- Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Anna Potyka
- Institute of Education and Communication Research, Silesian University of Technology in Gliwice, Gliwice, Poland
| | - Andrzej Paradysz
- Department of Urology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland
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Zhang X, Li X, Yu Q, Ma J, Zeng X, Xue L. Morbidity and All-Cause Mortality Following Radical Prostatectomy Compared with Observation for Localized Prostate Cancer in Chinese Men: A Non-Randomized Retrospective Study. Med Sci Monit 2021; 27:e928596. [PMID: 33612711 PMCID: PMC7908412 DOI: 10.12659/msm.928596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 01/05/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The Chinese 2018 guidelines and the current 2014 Chinese Urological Association guidelines for prostate cancer recommend radical prostatectomy for Chinese men with localized prostate cancer as the first choice, but it has treatment-related adverse effects. This study aimed to study morbidity and all-cause mortality following radical prostatectomy compared with observation for localized prostate cancer in Chinese men from a single center. MATERIAL AND METHODS Men diagnosed (histologically) as stage T1-T2N×M0 prostate cancer of any grade with 1-year history were included in the analysis. A total of 201 men underwent radical prostatectomy (RP cohort) and 209 men did not undergo radical prostatectomy (OS cohort). RESULTS During follow-up (17-24 years), 135 (67%) men died in the RP cohort and 156 (75%) men died in the OS cohort (P=0.103). All-cause mortality was lower for men with prostate-specific antigen level >10 ng/mL (P<0.0001), Gleason score ≥7 (P=0.004), and high D'Amico tumor risk scores (P=0.007) if they underwent radical prostatectomy. Age ≥65 years (P=0.041), Gleason score ≥7 (P=0.049), and tumor stage ≥2c (P=0.045) were associated with all-cause mortality. CONCLUSIONS The findings from this study showed that radical prostatectomy has no significant beneficial effects when compared with observation for Chinese men with localized prostate cancer, unless they had a prostate-specific antigen level >10 ng/mL, Gleason score ≥7, and high D'Amico tumor risk scores.
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Affiliation(s)
- Xi Zhang
- Department of Urology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, Jiangsu, P.R. China
| | - Xiang Li
- Department of Urology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, Jiangsu, P.R. China
| | - Qiwei Yu
- Department of Urology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, Jiangsu, P.R. China
| | - Jun Ma
- Department of Urology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, Jiangsu, P.R. China
| | - Xuemin Zeng
- Department of Urology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, Jiangsu, P.R. China
| | - Li Xue
- Department of Urology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, P.R. China
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Ergani B, Ozbilen MH, Yalcın MY, Boyacıoglu H, Ilbey YO. The effect of the type of surgery performed due to prostate cancer on preoperative patient anxiety, a prospective study. AMERICAN JOURNAL OF CLINICAL AND EXPERIMENTAL UROLOGY 2021; 9:88-95. [PMID: 33816697 PMCID: PMC8012827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/11/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Anxiety level in prostate cancer patients is common due to the increase in the incidence of prostate cancer diagnosis. We aimed to search for answers to the following questions such as whether there is preoperative anxiety in patients who will be operated for prostate cancer, what are the risk factors that may cause disease-induced anxiety and the type of surgery especially does robotic surgery reduce patient anxiety. METHOD The patients who were taken into operation were divided into 2 groups as Open Radical Retropubic Prostatectomy-Group 1 and Robot-Assisted Laparoscopic Radical Prostatectomy-Group 2. Age, active surveillance history, preoperative prostate spesific antigen (PSA) level, prostate biopsy pathology result, time between prostate biopsy and operation, state and trait anxiety scores of these patients were recorded. RESULT The study was conducted with a total of 149 patients; 61 patients in Group 1 and 88 patients in Group 2. The presence of active surveillance history, time between prostate biopsy and operation and state and trait anxiety levels were not found to be significant between both groups. However, it was concluded that the patients in Group 2 were significantly younger and operated with lower PSA and Gleason scores. The type of surgery had no effect on anxiety levels. CONCLUSION Preoperative information about the surgical procedure was found to be an effective factor in reducing anxiety. Regardless of the type of surgery we recommend that patients' anxiety should be reduced by explaining the surgical procedure to patients enough and in a way that they can understand.
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Affiliation(s)
| | - Mert Hamza Ozbilen
- University of Health Sciences Tepecik Training and Research Hospital Urology ClinicIzmir, Turkey
| | - Mehmet Yigit Yalcın
- University of Health Sciences Tepecik Training and Research Hospital Urology ClinicIzmir, Turkey
| | - Hayal Boyacıoglu
- Ege University Faculty of Science, Department of StatisticsIzmir, Turkey
| | - Yusuf Ozlem Ilbey
- University of Health Sciences Tepecik Training and Research Hospital Urology ClinicIzmir, Turkey
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Zhang S, Liang C, Qian J, Liu Y, Lv Q, Li J, Li P, Shao P, Wang Z. The Impact of Three Different Bladder Neck Reconstruction Techniques on Urinary Continence after Laparoscopic Radical Prostatectomy. J Endourol 2020; 34:663-670. [PMID: 32228027 DOI: 10.1089/end.2020.0064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Shaobo Zhang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chao Liang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jian Qian
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yiyang Liu
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qiang Lv
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jie Li
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Pu Li
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Pengfei Shao
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zengjun Wang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Luo X, Yi M, Hu Q, Yin W. Prostatectomy Versus Observation for Localized Prostate Cancer: A Meta-Analysis. Scand J Surg 2019; 110:78-85. [PMID: 31662032 DOI: 10.1177/1457496919883962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS Controversy exists regarding whether prostatectomy benefits localized prostate cancer patients; the aim of our study was to evaluate the role of prostatectomy in localized prostate cancer patients. MATERIALS AND METHODS A systematic search was conducted using PubMed and Web of Science through March 22, 2019, according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines to identify randomized studies reporting on prostatectomy for localized prostate cancer patients. RESULTS Of a total of 1827 studies, six were considered for evidence synthesis. A total of 2524 patients in 3 studies were included for survival analysis, where 1256 patients received prostatectomy and 1268 patients received no treatment but were regularly followed up. Three other studies were included for adverse effects analysis. Prostatectomy displayed a significantly decreased risk of death of 9% compared with that of observation for patients with localized prostate cancer (risk ratio = 0.91; 95% confidence interval, 0.85-0.97; p = 0.007). Pooled data indicated that prostatectomy reduced the risk of disease progression by 43% (risk ratio = 0.57; 95% confidence interval, 0.47-0.70; p < 0.00001). Anxiety, depressed mood, well-being, and sense of meaningfulness for patients were not different between the prostatectomy and observation groups. However, prostatectomy increased the risk of erectile dysfunction by 2.10-fold (risk ratio = 2.10; 95% confidence interval, 1.36-3.26; p = 0.0009) and the risk of urinary function problems by 2.02-fold (risk ratio = 2.02; 95% confidence interval, 1.15-3.54; p = 0.01). CONCLUSION Prostatectomy prolonged survival and deferred disease progression compared to observation for patients with localized prostate cancer. Symptoms between the two groups were not significantly different except for erectile and urinary function. Patients should decide on prostatectomy after balancing the survival benefit and risk of erectile dysfunction.
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Affiliation(s)
- Xiaojin Luo
- Department of Urology, The People's Hospital of Yichun City, Yichun, China
| | - Meilian Yi
- Department of Nursing, The People's Hospital of Yichun City, Yichun, China
| | - Qun Hu
- Department of Anesthesia, The People's Hospital of Yichun City, Yichun, China
| | - Weihua Yin
- Department of Oncology, The People's Hospital of Yichun City, Yichun, China
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