Factors affecting urinary continence and erecti̇le function after robot assisted laparoscopic radical prostatectomy

Background and aim: Robotic assisted radical prostatectomy (RARP) is one of the rapidly developing surgical techniques after the application of robotic systems worldwide. Better visualization of the surgery field, a sharper apical dissection, preserving a longer urethral length, the possibility of providing nerve protection, the lack of incisional morbidity, the less need for blood transfusion, and early healing have made the robotic approach an applicable method for radical prostatectomy. We aimed to evaluate the factors affecting postoperative urinary continence and erectile function in patients underwent RARP due to localized prostate cancer in our clinic. Materials and Methods: The study included 439 patients who underwent robotic assisted laparoscopic radical prostatectomy for stage I prostate cancer diagnosis at Ege University Faculty of Medicine Urology Department between March 2012 and January 2017. Patients' age, preoperative PSA value, prostate weights, postoperative tumor gleason score, operation time, transperitoneal posterior and anterior surgical approach, surgical margin and extraprostatic dissemination status were recorded. Continence and erectile function status of the patients were recorded during follow-up after the outpatient clinic and telephone interview. Statistical analysis of the data was performed with the SPSS 17.0 program. Results: There was no statistically significant difference for continence rates according to age, preoperative PSA, prostate volume, operation time, postoperative gleason score, surgical margin and extraprostatic extension status according to anterior and posterior approach (p> 0.05). On the other hand there was no statistically significant difference for erectile function among the patients in terms of prostate volume, operation time, postoperative gleason score, surgical margin and extraprostatic extension (p>0.05), while there was a statistically significant difference in terms of age (p<0.001), preoperative PSA (p=0.042) according to surgical approach technique. Conclusion: In our study, we found that postoperative urinary continence was not affected by the patient and disease-related factors while erectile function was VI affected by patient age, preoperative PSA value and operation technique in patients who underwent RARP due to prostate cancer. Key words: robot assisted radical prostatectomy; incontinence; erectile dysfunction.