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!

Lifestyle Management Program in Alberta – TrueNTH

The TrueNTH (pronounced True North) Lifestyle Management (LM) Program is part of the Global TrueNTH network funded by Movember (in partnership with Prostate Cancer Canada nationally). TrueNTH LM aims to improve the survivorship experience for men living with prostate cancer through physical activity, nutrition, and stress-reduction resources (programs and educational materials).

TrueNTH LM includes a free 12-week physical activity and yoga program with classes designed specifically to address the health and treatment related concerns for men living with prostate cancer. Men can also access a comprehensive online portal with tools, education, and home-based programming for help with staying active, reducing stress, and maintaining a proper diet.

In Calgary, TrueNTH LM has partnered with City of Calgary Recreation to offer programs at four different locations throughout the city. Registration is ongoing for men. In Edmonton, the Cancer Rehabilitation Clinic at the University of Alberta will be hosting a TrueNTH LM program starting in January 2016. Future programs will be announced as they become available. Men living in rural Alberta are able to join an online-based program at lifestyle.truenth.ca

All men who have been previously diagnosed with prostate cancer regardless of when they were diagnosed or what treatment they received can join the TrueNTH LM online portal or join a community program. Each person will undergo an initial health screening to ensure physical activity is safe.

For more information or to register, phone the Health and Wellness Lab in Calgary at .

Letter for participants

- Nicole Culos-Reed

Our International Network of Partners

Meeting these ambitious goals will not be possible without the committed engagement of our many partners across Alberta, Canada and the World. Learn more about our Partners.