Understanding early functional recovery after robotic prostatectomy.

OBJECTIVES

The time to regain urinary control and sexual function after robotic-assisted prostatectomy varies widely. The authors performed a study to prospectively assess relationships between intraoperative processes and early functional recovery after surgery.

METHODS

Prostate cancer patients undergoing robotic prostatectomy prospectively completed questionnaires (Expanded Prostate Cancer Index Composite-Short Form, Sexual Health Inventory for Men) preoperatively and at 3 months postoperatively. Relationships between intraoperative processes and early recovery were measured using multiple logistic regression.

RESULTS

At 3 months, 73.9% and 29.7% of patients had recovered urinary and sexual function, respectively. Bladder neck preservation was associated with early recovery of both urinary and sexual function (P < .01). The quality of nerve sparing (P = .01), seminal vesicle sparing (P = .03), and the use of urethral suspension (P = .04) were associated with early recovery of sexual function.

CONCLUSIONS

Early functional recovery for patients undergoing robotic-assisted prostatectomy varies by both patient characteristics and process measures. The causal link between intraoperative processes and patient outcomes merits further study through quality improvement collaboratives.