AB015. Nerve-sparing radical prostatectomy: experience from laparoscopic and robotic approaches

OBJECTIVE: To review and analyze the patients underwent nerve-sparing radical prostatectomies in the First Affiliated Hospital of Anhui Medical University. METHODS: The clinical data of patients who underwent both laparoscopic radical prostatectomy and robotic radical prostatectomy in department of Urology of The First Affiliated Hospital of Anhui Medical University between November 2006 and March 2015 were analyzed retrospectively. Indexes of preoperative parameters, operating time, blood loss during operation, blood transfusions rate, recovery time of intestinal function, the duration of catheterization, hospitalization stay after operation, complications, continence rate, potency rate and biochemical recurrence of the procedures were observed. RESULTS: We mainly use scissors to dissect sharply between prostate and levator fascia, avoiding the application high-energy devices. Therefore, the possibility of NVB injury was reduced while blunt dissection. In addition, intra fascial nerve-sparing technique was also applied in patients diagnosed at T1 stage. When the base of the seminal vesicles isolated, the dissection was perform between the prostatic capsule and prostatic fascia, yielding the maximum retention of NVB. The nerve-sparing approaches resulted in satisfactory outcome of urinary continence as well as the erectile function. Furthermore, the biochemical progression-free-survival rates and the perioperative parameters were similar comparing to the patients without a nerve-sparing technique. CONCLUSIONS: Under strict indications, the nerve-sparing radical prostatectomy yielding much preferable outcomes of urinary continence and erectile function with a similar result of oncological outcome.