PMID- 22524628
OWN - NLM
STAT- MEDLINE
DCOM- 20130116
LR  - 20220311
IS  - 1557-900X (Electronic)
IS  - 0892-7790 (Linking)
VI  - 26
IP  - 9
DP  - 2012 Sep
TI  - Extended nodal dissection reduces sexual function recovery after robot-assisted 
      laparoscopic prostatectomy.
PG  - 1192-8
LID - 10.1089/end.2012.0011 [doi]
AB  - BACKGROUND AND PURPOSE: Considering the anatomic proximity of the internal iliac 
      lymph nodes and the pelvic plexus, it may be expected that more extensive pelvic 
      nodal dissection is associated with an increased risk of damage to the small 
      pelvis neural and vascular structures. We evaluate whether nodal dissection is 
      associated with functional outcome after robot-assisted radical prostatectomy 
      (RARP). PATIENTS AND METHODS: In a series of 798 RARP procedures, 325 (40.7%) 
      patients underwent a lymph node dissection. Continence, sexual function, and 
      lower urinary tract symptoms (LUTS) were assessed using the International 
      Consultation of Incontinence Questionnaire short form (ICIQ)-SF), International 
      Index of Erectile Function-15, and European Organisation for Research and 
      Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ)-PR25 questionnaires 
      before and at 6 months intervals after RARP. RESULTS: Preoperative ICIQ-SF, 
      IIEF-15, and PR25-LUTS scores were similar for men with and without nodal 
      dissection. Normal postoperative erectile function (IIEF-EF >24) at 6 months was 
      reported by 1.7%, 9.1%, and 50.4% of men with no, unilateral, and bilateral nerve 
      preservation and normal preoperative erectile function. All domains of the 
      IIEF-15 score showed a negative correlation with the number of removed lymph 
      nodes. In 70 of 325 (21%) cases with nodal dissection, more than 10 nodes were 
      removed. Men with more than 10 nodes removed had lower IIEF-15 domain scores 
      compared with men with 1 to 10 removed lymph nodes. The postoperative ICIQ-SF and 
      PR25-LUTS scores were not associated with extent of nodal dissection. Nodal 
      metastases were found in 5.9% and 15.7% of men with </= 10 nodes and >10 nodes 
      removed (P=0.005). In a multivariate analysis, extent of fascia preservation 
      (FP-score), preoperative IIEF-EF, and number of removed nodes were the strongest 
      independent predictors of postoperative erectile function recovery. CONCLUSION: 
      More extensive nodal dissection was associated with impaired postoperative sexual 
      function recovery but not continence and voiding function after RARP, independent 
      of preoperative function and nerve preservation.
FAU - van der Poel, Henk G
AU  - van der Poel HG
AD  - Department of Urology, Netherlands Cancer Institute , Amsterdam, The Netherlands 
      .
FAU - Tillier, Corinne
AU  - Tillier C
FAU - de Blok, Willem
AU  - de Blok W
FAU - van Muilekom, Erik
AU  - van Muilekom E
LA  - eng
PT  - Journal Article
DEP - 20120625
PL  - United States
TA  - J Endourol
JT  - Journal of endourology
JID - 8807503
SB  - IM
CIN - J Urol. 2013 May;189(5):1717-8. PMID: 23594630
MH  - Demography
MH  - Erectile Dysfunction/etiology/physiopathology
MH  - Humans
MH  - Laparoscopy/*adverse effects
MH  - Logistic Models
MH  - Lymph Node Excision/*adverse effects
MH  - Lymph Nodes/pathology/surgery
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Preoperative Care
MH  - Prostatectomy/*adverse effects
MH  - *Recovery of Function
MH  - *Robotics
MH  - Sexual Dysfunction, Physiological/*etiology
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
EDAT- 2012/04/25 06:00
MHDA- 2013/01/17 06:00
CRDT- 2012/04/25 06:00
PHST- 2012/04/25 06:00 [entrez]
PHST- 2012/04/25 06:00 [pubmed]
PHST- 2013/01/17 06:00 [medline]
AID - 10.1089/end.2012.0011 [doi]
PST - ppublish
SO  - J Endourol. 2012 Sep;26(9):1192-8. doi: 10.1089/end.2012.0011. Epub 2012 Jun 25.