Publications

Publications

Urinary outcomes are significantly affected by nerve sparing quality during radical prostatectomy

By:
Contributors: Eric Hyndman, MD, PhD

Urology. 2013 Dec;82(6):1348-53. doi: 10.1016/j.urology.2013.06.067. Epub 2013 Oct 3.

Kaye DR1, Hyndman ME, Segal RL, Mettee LZ, Trock BJ, Feng Z, Su LM, Bivalacqua TJ, Pavlovich CP.

Abstract

OBJECTIVE:

To assess the effect of nerve sparing (NS) quality on self-reported patient urinary outcomes after radical prostatectomy.

METHODS:

A total of 102 preoperatively potent men underwent laparoscopic or robotic radical prostatectomy; NS was prospectively graded at surgery using a 0-4 scale/neurovascular bundle. Urinary functional outcomes were measured by validated Expanded Prostate Cancer Index Composite questionnaire at baseline and follow-up time points (1, 3, 6, 9, and 12 months) in 99 men who underwent various degrees of NS. Mixed linear regression was used to analyze the effect of NS quality and other clinical factors on urinary outcomes.

RESULTS:

Patients with at least 1 neurovascular bundle spared completely, along with its supportive tissues (NS grade 4/4), noted significantly improved Expanded Prostate Cancer Index Composite urinary functional and continence outcomes as early as 1 month postoperatively and up to 12 months. Significantly less urinary bother was also noted in these men by 9-12 months postoperatively. Multivariate analysis revealed that bilateral or unilateral excellent NS (at least 1 bundle graded 4/4), increasing time from surgery, young patient age, and lower body mass index positively and significantly affected urinary functional outcomes, including pad use. Men who received excellent unilateral NS recovered urinary function about as well as men who had both neurovascular bundles spared in similar fashion.

CONCLUSION:

The quality of NS significantly influences patient-defined urinary functional convalescence. Completely sparing at least 1 neurovascular bundle along with its supportive tissues has a dramatic effect on the recovery of urinary continence and quality of life in preoperatively potent men.

 

PubMed

Download PDF

 

Stay Informed

To stay up to date on all the latest news and publications, subscribe to our newsletter!

New platform for prostate cancer diagnosis to be presented at ISEV 2017

The Lewis Research Group will present exciting results about new blood tests for prostate cancer during 3 talks at the upcoming 2017 International Society of Extracellular Vesicles (ISEV) annual meeting in Toronto (May 18-21). ISEV is a global society of researchers studying exosomes and microvesicles, which are the exciting new focus of cancer therapy and diagnosis.

Dr. Desmond Pink will speak about “Microflow cytometry: The Apogee A50 is a sensitive standard tool for extracellular vesicle analyses in liquid biopsies”, Robert Paproski’s presentation is entitled “Using machine learning of extracellular vesicle flow cytometry to build predictive fingerprints for prostate cancer diagnosis”, and Dr. John Lewis will speak about “An extracellular vesicle blood fingerprint distinguishes between patients with indolent and aggressive prostate cancer at diagnosis”.

The team is looking forward to sharing these key advances that were made possible through the APCaRI prospective cohort.

- John Lewis