PMID- 30857988
OWN - NLM
STAT- MEDLINE
DCOM- 20200305
LR  - 20200305
IS  - 1873-2496 (Electronic)
IS  - 1078-1439 (Linking)
VI  - 37
IP  - 5
DP  - 2019 May
TI  - Impact of the estimated blood loss during radical prostatectomy on functional 
      outcomes.
PG  - 298.e11-298.e17
LID - S1078-1439(19)30007-9 [pii]
LID - 10.1016/j.urolonc.2019.01.006 [doi]
AB  - OBJECTIVE: To investigate the effect of the estimated blood loss (BL) during 
      radical prostatectomy (RP) for prostate cancer (CaP) on functional outcomes. We 
      hypothesized that the estimated BL during RP for clinically localized CaP does 
      not affect the functional outcomes. MATERIALS AND METHODS: Patients who underwent 
      open RP (ORP) or robotic-assisted laparoscopic RP (RALP) were identified. BL was 
      stratified into low, medium and high: </=500vs. >500 to 1000vs. >1,000ml for ORP 
      and </=150vs. >150 to 400vs. >400ml for RALP. Multivariable logistic regression 
      models (MLRM) tested the effect of BL on functional outcomes. RESULTS: About 
      6,279 consecutive patients with ORP (2008-2015) and 2,720 patients with RALP 
      (2009-2015) were identified. Low, medium, and high BL was recorded in 31.4vs. 
      45.7vs. 22.9% for ORP and in 39.8vs. 45.2vs.15.0% for RALP. MLRM predicting 
      potency revealed that high BL was an independent predictor for erectile 
      dysfunction: Odds ratios (OR) were 0.50 (P = 0.03) and 0.52 (P = 0.04) for ORP 
      and RALP, respectively. MRLM predicting continence in ORP revealed that high BL 
      was an independent predictor for 7-days and mid-term: ORs were 0.80 (P = 0.04) 
      and 0.66 (P = 0.002). Moreover, high BL was an independent predictor for 7-days 
      continence in RALP: OR were 0.68 (P = 0.009). CONCLUSION: CaP patients who 
      sustain higher BL during RP showed worse functional outcomes. High BL during ORP 
      or RALP represented an independent predictor of erectile dysfunction and 
      incontinence after surgery. However, the effect of high BL on the continence was 
      temporarily and not present at 1 year after surgery in ORP and after 3 months in 
      RALP.
CI  - Copyright (c) 2019. Published by Elsevier Inc.
FAU - Preisser, Felix
AU  - Preisser F
AD  - Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, 
      Hamburg, Germany; Cancer Prognostics and Health Outcomes Unit, Division of 
      Urology, University of Montreal Health Center, Montreal, Quebec, Canada.
FAU - Pompe, Raisa S
AU  - Pompe RS
AD  - Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
FAU - Salomon, Georg
AU  - Salomon G
AD  - Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, 
      Hamburg, Germany.
FAU - Rosenbaum, Clemens
AU  - Rosenbaum C
AD  - Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
FAU - Graefen, Markus
AU  - Graefen M
AD  - Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, 
      Hamburg, Germany.
FAU - Huland, Hartwig
AU  - Huland H
AD  - Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, 
      Hamburg, Germany.
FAU - Karakiewicz, Pierre I
AU  - Karakiewicz PI
AD  - Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of 
      Montreal Health Center, Montreal, Quebec, Canada.
FAU - Tilki, Derya
AU  - Tilki D
AD  - Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, 
      Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, 
      Hamburg, Germany. Electronic address: d.tilki@uke.de.
LA  - eng
PT  - Journal Article
DEP - 20190308
PL  - United States
TA  - Urol Oncol
JT  - Urologic oncology
JID - 9805460
SB  - IM
MH  - Aged
MH  - Blood Loss, Surgical/*statistics & numerical data
MH  - Erectile Dysfunction/*epidemiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/*epidemiology
MH  - *Prostatectomy/methods
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Urinary Incontinence/*epidemiology
OTO - NOTNLM
OT  - Blood loss
OT  - Erectile function
OT  - Functional outcome
OT  - Incontinence
OT  - Prostatectomy
OT  - Robotic-assisted prostatectomy
EDAT- 2019/03/13 06:00
MHDA- 2020/03/07 06:00
CRDT- 2019/03/13 06:00
PHST- 2018/07/30 00:00 [received]
PHST- 2018/11/11 00:00 [revised]
PHST- 2019/01/03 00:00 [accepted]
PHST- 2019/03/13 06:00 [pubmed]
PHST- 2020/03/07 06:00 [medline]
PHST- 2019/03/13 06:00 [entrez]
AID - S1078-1439(19)30007-9 [pii]
AID - 10.1016/j.urolonc.2019.01.006 [doi]
PST - ppublish
SO  - Urol Oncol. 2019 May;37(5):298.e11-298.e17. doi: 10.1016/j.urolonc.2019.01.006. 
      Epub 2019 Mar 8.