Erectile Dysfunction Following Radical Prostatectomy, Incontinence Stress, Prostate Adenocarcinoma
Conditions
Brief summary
After robotic prostatectomy, besides erectile function and achievement of oncological control, staying dry is also a very important desire expressed frequently by the patients. This has led to the concept of trifecta achievement after robotic prostatectomies. Hence, continence preserving prostatectomies are the order of the day today. Patient acceptance to surgery is low if the continence cannot be assured preoperatively. Many techniques have been promulgated in the last two decades. The investigators present a novel technique of maximal urethral length preservation during surgery as an effective method of continence preservation. The investigators hypothesize that maximal preservation of urethra would lead to improved and early continence after robotic prostatectomy. The investigators also hypothesize that urethral preservation spares penile length shortening. The investigators therefore propose to prospectively evaluate penile length shortening. While penile length change after radical prostatectomy has been studied in the past, the investigators like to assess the penile morphometric assessment following the novel technique of maximal urethral length preservation radical prostatectomy.
Interventions
PROCEDUREMaximal urethral length preservation technique of robot assisted radical prostatectomy (RALP).
Stretched flaccid penile length (SFPL) was measured by a single male assessor at preoperative visit, and at the time of catheter removal (10 days post-surgery). The subjects were blinded to the measurements to prevent bias. Multiparametric MRI (MP-MRI) of the prostate were reviewed when available for surgical planning. All subjects underwent RALP with MULP using the technique previously published by Hamada et al. Continence defined as requiring no pads was assessed at 3 and 6 months postoperatively.
Sponsors
Larkin Health System
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Masking description
Stretched flaccid penile length (SFPL) was measured by a single male assessor at preoperative visit, and at the time of catheter removal (10 days post-surgery). The subjects were blinded to the measurements to prevent bias.
Intervention model description
In an IRB approved study, we prospectively evaluated the stretched flaccid penile length (SFPL) pre and post robot assisted laparoscopic radical prostatectomy (RALP) in subjects with a diagnosis of prostate cancer. The multiparametric MRI (MP-MRI) was utilized for surgical planning if available preoperatively. Repeated measures t-test, linear regression and 2-way ANOVA analyses were performed.
Eligibility
Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
All men undergoing robot assisted laparoscopic radical prostatectomy (RALP). \-
Exclusion criteria
1. Exposure to androgen deprivation therapy 2. Prior treatment for prostate cancer 3. Metastatic prostate cancer 4. History of hypospadias or urethral reconstruction 5. History of penile implant, intracorporal injections, intraurethral suppositories 6. Prior pelvic surgery. -
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Penile Length | 10 days post operatively | Stretched Flaccid Penile Length |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Urinary continence | 3 months and 6 months postoperatively | Pads used. |
Countries
United States
Outcome results
None listed