Prostate cancer is the most widely recognised malignancy in males. In the United Kingdom (UK), about 1 in 8 men will be diagnosed with prostate cancer in their lifetime. This increased incidence of prostate cancer has prompted modifications in treatment techniques. We aimed to study the health-related quality of life (QOL) outcomes following robotic-assisted laparoscopic prostatectomy (RALP) and open radical prostatectomy (ORP) focusing particularly on urinary continence and potency. A literature search was performed using PubMed, Clinical Key, and EBSCOhost databases.
We limited our search to English-language articles between 2008 and 2015. The following keywords were used: open radical prostatectomy (ORP), robotic-assisted laparoscopic prostatectomy (RALP), quality of life (QOL), urinary continence, sexual function, potency. Urinary incontinence is a common postoperative long-term complication following prostatectomy. Postoperative urinary continence recovery is measured 12 months after the procedure and defined as usage of 0-1 pad per day. Inge et.al reported that RALP group regain continence much sooner than ORP group, with a significant p-value of 0.007.
1 However, another study showed that in between RALP and ORP group, statistical data of patients still presenting with urinary incontinence after 1 year did not differ significantly.2 Erectile dysfunction is another complication that might occur in patients. A study conducted in 2013 compared the erectile function at 3-, 6-, and 12-months follow up, it was noted that recovery of potency was more rapid in RALP group, with 36% of patients in RALP group recovering potency within 6 months compared to only 10% in ORP group.3 However, potency rates between the RALP and ORP group 12 months postoperatively did not differ significantly.2 In conclusion, patients undergoing RALP demonstrated earlier recovery of both continence and potency. Interestingly, both RALP and ORP groups showed similar recovery of functions a year later.
These estimates of QOL 12 months after surgery should be helpful to urologists in enabling a patient-centred treatment approach.