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

 

It’s Movember, time to Grow a Mo for a Bro!

It’s Movember, time to grow your moustache to raise funds and awareness of some serious health risks that men face, like suicide, testicular cancer and prostate cancer. Maybe growing a moustache isn’t your thing? No problem, host a Mo-ment for the men in your life instead!

APCaRI is a key stakeholder in the TrueNTH Global Registry; contributing 92% of the submitted patients in February 2018. Recently described by Evans et al., 2017 in an article published in BMJ Open, this project was established as an international registry with the goal to monitor the care of men with localised prostate cancer from 13 Movember-fundraising countries. Prostate cancer treatment and outcomes for men vary according to where they live, their race and the care they receive. The TrueNTH Global Registry is collecting a dataset based on the International Consortium for Health Outcome Measures (ICHOM) so we can better understand how to improve the care and treatment of men with localized prostate cancer, regardless of ethnicity and geography.

Please check out previous APCaRI blog posts that have talked about Movember (@Movember); the international Mens’ health Awareness charity, and about TrueNTH (@TrueNTH_Canada); a program funded by Prostate Cancer Canada (PCC) and the Movember Foundation that aims to improve the quality of life of men with prostate cancer and their families.

So start growing (or attach) your moustache today to raise funds and awareness to improve mens’ health!

- Perrin Beatty