Neha Sharma MD, Presenter: Nothing to Disclose

Dattatreyudu Nori MD, Abstract Co-Author: Nothing to Disclose

K. S. Clifford Chao MD, Abstract Co-Author: Nothing to Disclose

A common concern of patients requiring adjuvant or salvage radiotherapy for prostate cancer is their quality of life following treatment. We aimed to evaluate urinary continence and sexual potency in patients treated with robotic-assisted radical prostatectomy followed by radiotherapy.

From March 2005 to February 2009, 32 patients underwent robotic-assisted radical prostatectomy followed by radiotherapy. All patients had T1-T3, N0 prostate cancer with Gleason scores ranging from 6-9 on evaluation of prostatectomy specimen. Patients underwent robotic-assisted radical prostatectomy by experienced surgeons at our institution. Patients were then treated with intensity-modulated radiation therapy to a dose of 7020cGy delivered to the prostate bed. Thirteen patients (40.6%) were treated with adjuvant radiation and 19 patients (59.4%) were treated in the salvage setting. Data including American Urological Association scores, International Prostate Symptom Scores, and International Index of Erectile Function questionnaires were utilized along with general patient reporting to evaluate urinary continence and erectile function. Data was obtained from patients prior to radical prostatectomy, post-operatively prior to initiation of radiotherapy, and following the completion of radiotherapy.

Of the 32 patients followed, 30 (93.8%) reported full urinary continence without any urinary leakage prior to surgery. Prior to initiation of radiotherapy, 23 (76.7%) of the group reported “decreased” urinary continence, with 6 (20.0%) reporting “severe” urinary incontinence. As of last follow-up, following radiotherapy, only 2 patients (6.3%) reported “severe” urinary incontinence. Twenty-six patients reported “good” erectile function prior to prostatectomy. Eighteen (69.2%) of this group reported “decreased” erectile function prior to initiation of radiotherapy. As of last follow-up, following radiotherapy, 16 patients (61.5%) reported “good” erectile functioning.  

Radiotherapy after robotic-assisted radical prostatectomy does not appear to significantly hinder recovery of post-operative urinary incontinence and erectile function.

This data is relevant to addressing patient concerns about decline in urinary continence and sexual functioning following post-prostatectomy radiotherapy.

Sharma, N, Nori, D, Chao, K, Quality of Life after Robotic-assisted Radical Prostatectomy Followed by Radiotherapy.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9009708.html