A prospective study of transition from laparoscopic to robot-assisted radical prostatectomy: quality of life outcomes after 36-month follow-up

Objective: To compare quality of life (QOL) outcomes after conversion from laparoscopic radical prostatectomy (LRP) to robot-assisted radical prostatectomy (RALP) as the routine procedure for surgical treatment of localized cancer of the prostate (CaP).

Methods: In November 2007, we changed the routine operative technique for localized CaP from LRP to RALP. The last 210 consecutive patients operated with LRP were compared with the first 210 consecutive patients operated with RALP. The patients were mailed University of California Los Angeles-Prostate Cancer Index (UCLA-PCI) and Short Form Health Survey (SF)-12 questionnaires at baseline and at 3, 12, and 36-month follow-up.

Results: In the LRP group, 89.0%, 93.8%, 93.8%, and 88.1% of patients answered questionnaires at baseline and at 3, 12, and 36-month follow-up. The corresponding numbers in the RALP group were 92.4%, 94.3%, 85.7%, and 76.4%. At 36-month follow-up, 87.9% and 82.6% of LRP and RALP patients, respectively, had regained baseline urinary function score (ns). At 36-month follow-up, 57.3% and 61.3% of LRP and RALP patients, respectively, had regained baseline sexual function score (ns). Nerve-sparing surgical procedures mitigated the adverse effects on sexual function in both groups. Surgical method was not associated with urinary function and sexual function at 36 months. Better urinary function was associated with better general mental health.

Conclusion: Introduction of RALP did not result in improvement of functional outcome. There was no difference regarding urologic function/bother score or sexual function/bother score at 36-month follow-up in patients treated with LRP or RALP.