Understanding Early Functional Recovery After Robotic Prostatectomy

Abstract

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.