Evaluation of surgical and functional outcomes after bilateral intrafascial nerve-sparing laparoscopic radical prostatectomy after prostate resection for incidental prostate cancer

Objective: To evaluate the impact of nerve-sparing laparoscopic radical prostatectomy after TUR-P (nsLRPT) on surgical and functional outcomes, by using validated questionnaire in patients affected by incidental prostate cancer. Materials and Methods: Retrospective single surgeon study including 125 consecutive patients who underwent a nsLRPT for incidental prostate cancer diagnosed. International index of erectile function (IEEF5) was administered preoperatively, and at 3, 6 and 12 months postoperatively. Potency was defined as a score >17 points. Clinical data were also recorded at each time point. Results: The mean operative time was 153.1±35.4 min with a mean intraoperative blood loss of 350.3±150.4 ml and a transfusion rate of 1.6%. The mean catheterization time was 5±1 days and the mean length of hospitalization results to be shorter after nsLRPT was 6.2±2.1 days. No major complications occurred in both groups. Positive margins were detected in only 1 patient (1.8%) with a pT2c tumour. Nevertheless, at a median follow-up of 48 months, all patients were alive with no evidence of tumour recurrence. At the 12 th months, a complete continence was reported in 98.4% of patients who underwent surgery. Regarding sexual potency, 52% and 78.4% of all patients reported the ability to engage in sexual intercourse at 6- and 12- months after surgery, respectively. Conclusion: NsLRP after TUR-P, performed by expert surgeons, results to be a safe procedure with excellent functional outcomes with regard to the urinary continence and sexual potency. Keywords: B ilateral intrafascial nerve-sparing radical prostatectomy, incidental prostate cancer, laparoscopy, transurethral prostate resection, sexual function, outcomes