Objectives: Most of the previously reported patient selection criteria for nerve-sparing radical prostatectomy were based on conventional sextant biopsy, and those based on extended biopsy have been scarcely investigated. In the current study, we developed patient selection criteria for nerve-sparing RP based on the three-dimensional 26-core (3D26) biopsy-derived variables.
Methods: We evaluated 202 non-nerve-spared sides in 109 consecutive patients in whom prostate cancer was diagnosed by the 3D26 biopsy and who underwent RP without neoadjuvant treatment. Associations of clinical and pathological variables with side-specific posterolateral extraprostatic extension (SS-PL-EPE) were analyzed. Subgroup analysis using transperineal 14-core (TP14) and transrectal 12-core (TR12) biopsies as representative subsets of the 3D26 biopsy was also performed.
Results: Maximum cancer length in positive cores > or =5 mm and biopsy Gleason score > or =4 + 3 were independent and were significant risk factors of SS-PL-EPE in the 3D26 cohort at multivariate analysis. In the prostatic side with none, one, and two risk factors, the incidences of SS-PL-EPE were 0, 14 and 52% in the 3D26 cohort, 3.4,15 and 57% in the TP14 cohort and 2.6, 20 and 61% in the TR12 cohort, respectively.
Conclusions: We developed simple patient selection criteria for nerve-sparing RP. According to our criteria, the nerve-sparing side can be selected in the majority of patients who undergo the 3D26, TP14 or TR12 biopsy with a less-than-4% risk of SS-PL-EPE.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/j.1442-2042.2008.02162.x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Development and validation of nomograms for predicting pentafecta outcomes before and after robot-assisted radical prostatectomy: a retrospective study.
Sci Rep
January 2025
Department of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
Prostate cancer (PCa) is one of the most common cancers among men worldwide, and robot-assisted radical prostatectomy (RARP) is a widely used treatment for localized PCa. Achieving pentafecta outcomes, which include continence, potency, cancer control, free surgical margins, and no major complications, is a critical measure of surgical success and long-term prognosis. However, predicting these outcomes remains challenging.
View Article and Find Full Text PDFImpact of Posterior Tibial Nerve Stimulation on Early Continence Following Extraperitoneal Laparoscopic Radical Prostatectomy With Three Trocars.
Neurourol Urodyn
January 2025
Department of Urology, School of Medicine, Sanko University, Gaziantep, Turkey.
Aim: Posterior tibial nerve stimulation (PTNS) might stimulate the sacral nerves and lead to work pelvic floor muscles. We evaluated to effects of PTNS on continence results after extraperitoneal laparoscopic radical prostatectomy (eLRP) with three trocars during early post operative period.
Methods: Prospectively recorded data of eLRP with three trocars was retrospectively reviewed for continence results between January 2017 and April 2024.
Impact of neurovascular bundle preservation on biochemical recurrence after robot-assisted radical prostatectomy for high-risk prostate cancer.
World J Urol
December 2024
Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Purpose: To evaluate functional and oncological outcomes in patients who underwent unilateral or bilateral nerve-sparing (NS) robot-assisted radical prostatectomy (RARP) for high-risk prostate cancer.
Methods: The cohort comprised 2683 patients with clinical stage T1-4, N0M0 high-risk prostate cancer who underwent RARP in Japanese tertiary care centers from August 2011 to April 2023. High risk was defined using the European Association of Urology risk stratification criteria.
Unilateral nerve preservation during parametrectomy is not sufficient to prevent persistent urinary retention after cytoreductive endometriosis surgery.
Arch Gynecol Obstet
December 2024
Urology, Federal Hospital of Lagoa, Rua Pio Correa 110, 506, Jardim Botânico, Rio de Janeiro, 22462-240, Brazil.
Article Synopsis
- The study aimed to measure the risk of urinary retention after different levels of nerve preservation during surgeries for deep endometriosis.
- Out of 151 participants, most had excellent nerve preservation, but those with poor preservation (P3 group) experienced a higher incidence of urinary retention and needed catheterization.
- The findings indicate that poor nerve preservation during parametrectomy significantly increases the likelihood of urinary retention, even if the nerves on the opposite side remain intact.
Nerve-sparing techniques in robot-assisted radical prostatectomy - anatomical approach.
Expert Rev Med Devices
December 2024
Department and Chair of Urology and Andrology, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
Introduction: Nerve-sparing (NS) techniques in robot-assisted radical prostatectomy (RARP) are foundational to preserving sexual function and urinary continence in prostate cancer (PCa) patients.
Areas Covered: This article aims to classify nerve-sparing (NS) techniques in RARP based on an anatomical approach to the prostate. We have identified three main NS approaches in RARP: anterior, lateral, and posterior.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!