Prostatectomía radical asistida por robot: resultados funcionales

Abstract

OBJECTIVES: To present a contemporary review of the functional outcomes following robotic-assisted radical prostatectomy based on published postoperative erectile function and urinary continence data. METHODS: A review of the available literature on Medline and PubMed databases was performed. RESULTS: Factors affecting erectile function include age, preoperative SHIM scores, co-morbidities and nerve sparing techniques. Large robotic-assisted laparoscopic radical prostatectomy (RALP) series like the Vattikuti Institute's and Ohio State University's demonstrate early potency outcomes: 70% and 80% of patients, respectively, who underwent bilateral nerve sparing and had a pre-operative SHIM score > 17, regained potency after a follow-up of 12 months. This has also been reproduced by smaller series, where 43% of patients achieved potency within 3 months postop and 68%, 79% of patients who underwent unilateral or bilateral nerve sparing, respectively, were able to have intercourse with or without PDE5 inhibitors after 12 months follow-up. Postoperative continence rates after RALP for larger series are 76%-92% and 95. 2%-98% while that for smaller series range from 76% and 89% at 3 and 12 months, respectively. CONCLUSIONS: RALP is a safe, minimally invasive procedure that produces functional outcomes comparable to contemporary results of both open and laparoscopic prostatectomy.