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Association of nerve-sparing grading in robotic radical prostatectomy and trifecta outcome

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Abstract

Purpose

To evaluate the neurovascular bundle preservation grades during robotic-assisted radical prostatectomy and compared to the trifecta combined outcome (oncologic control, continence, and sexual function) twelve months after the surgery.

Methods

Cohort of patients who underwent nerve-sparing robotic-assisted radical prostatectomy had the neurovascular bundle preservation retrospectively graded from 0 to 8 according to the Hopkins subjective visual classification. Patients then were divided into two groups, according to the median of nerve-sparing grading: those with score six or high and those with score less than six. Main outcome was the trifecta combined outcome and secondary outcomes was the individual trifecta criteria (prospective analysis). A secondary analysis with groups divided according to pre-operatory SHIM score was made.

Results

One hundred robotic-assisted nerve-sparing radical prostatectomy were performed, of which 83 were included. There were 53 patients with grading greater than or equal to six (group 1) and 30 patients less than six (group 2). 66.6% patients (35/53) in group 1 had a trifecta combined outcome of compared to 33.3% (10/30) in group 2 (p = 0.017). Individually, the erectile function was higher in group 1 (73.6%) compared to group 2 (46.7%) (p = 0.014). Both the results of the combined endpoint trifecta and erection were also maintained in the group with preoperative SHIM ≥ 17.

Conclusions

The grading of preservation of the neurovascular bundle in radical prostatectomy is related to a better combined trifecta outcome one year after surgery.

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Funding

The authors did not receive support from any organization for the submitted work. No funds, grants, or other support was received.

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Authors and Affiliations

  1. Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Bairro Santa Cecília, Porto Alegre, RS, Brazil

    Antônio Rebello Horta Görgen, Lucas Medeiros Burttet, Eduardo Tosetto Cachoeira, Pedro Glusman Knijnik, Pietro Waltrick Brum, Artur de Oliveira Paludo, Renan Desimon Cabral, Tiago Elias Rosito, Milton Berger & Brasil Silva Neto

  2. Programa de Pós-Graduação em Ciências Cirúrgicas, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil

    Antônio Rebello Horta Görgen & Brasil Silva Neto

  3. Johns Hopkins Hospital, Baltimore, MD, USA

    Christian Paul Pavlovich

Authors
  1. Antônio Rebello Horta Görgen
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  2. Lucas Medeiros Burttet
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  3. Eduardo Tosetto Cachoeira
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  4. Pedro Glusman Knijnik
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  5. Pietro Waltrick Brum
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  6. Artur de Oliveira Paludo
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  7. Renan Desimon Cabral
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  8. Tiago Elias Rosito
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  9. Milton Berger
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  10. Christian Paul Pavlovich
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  11. Brasil Silva Neto
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Contributions

ARHG: Protocol/project development, Data collection or management, Data analysis, Manuscript writing/editing. LMB: Protocol/project development, Data analysis, Manuscript writing/editing. ETC: Data collection or management. PGK: Data collection or management. PWB: Data collection or management. AOP: Data collection or management. RDC: Protocol/project development, Data analysis. TER: Protocol/project development, Data analysis. MB: Protocol/project development, CPP: Protocol/project development, Manuscript writing/editing. BSN: Protocol/project development, Manuscript writing/editing.

Corresponding author

Correspondence to Antônio Rebello Horta Görgen.

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Conflict of interest

The authors have no competing interests to declare that are relevant to the content of this article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the research ethics committee of our hospital, under the number CAAE 02658218.0.0000.5327. The previously collected database had also been approved by the research ethics committee, under number CAAE 59735716.2.0000.5327.

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Informed consent was obtained from all individual participants included in the study.

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Görgen, A.R.H., Burttet, L.M., Cachoeira, E.T. et al. Association of nerve-sparing grading in robotic radical prostatectomy and trifecta outcome. World J Urol 40, 2925–2930 (2022). https://doi.org/10.1007/s00345-022-04196-9

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  • DOI: https://doi.org/10.1007/s00345-022-04196-9

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