The findings of the study suggested that outcomes of the minimally-invasive prostate-removing surgery are not uniformly superior to the open approach.
To find out whether minimally-invasive prostatectomy -- surgical removal of all or part of the prostate gland -- really work as well as open surgery, Dr. Jim Hu of Brigham and Women's Hospital in Boston and colleagues analyzed prostate surgery outcomes for nearly 9,000 men who had surgical treatment from 2003-07.
Out of these, 1,938 patients underwent minimally-invasive surgery and 6,899 patients had standard surgery.
The researchers noted that both open and minimally-invasive surgery (both manual and robotic) fared equally well as a cancer
treatment. However, there were big differences in the outcomes of the two surgical procedures.
High-tech prostate surgery and genital problems
The findings of the study suggested that patients who underwent the more high-tech surgery spent an average of two days in hospital, as compared to three-days in traditional procedure.
Researchers observed that those patients were also less likely to require blood transfusions or suffer respiratory or surgical complications.
However, men who had the robotic surgery were more likely to report urinary and genital complications in the first 30 days of the surgery. It was also noted that these men reported more complications like incontinence and erectile dysfunction after a period of 18 months.
"We found men undergoing minimally invasive versus open surgery were more likely to have a diagnosis of incontinence and erectile dysfunction," said Hu.
The researchers also observed that the less-invasive surgery was more popular among highly-educated men. So they speculated that those patients were more likely to seek help for urinary and sexual problems compared to men who had traditional surgery.
"There's been a rapid adoption of this relatively new technique," Hu said.
"The take-home message for men is they need to dig deeper than simply the message they might be getting from planted stories from device manufacturers or radio ads or billboards," Hu added.
Robotic surgery lowers pain
The researchers said that the minimally-invasive surgery system consists of robotic arms, controlled from a console, that allow surgeons to perform less invasive surgeries.
Experts opine that such systems are able to reduce trauma, blood loss, risk of infection, scarring and often pain.
The study appears in the Journal of the American Medical Association.
Prostate Cancer
Any discussion of a Radical Prostatectomy (RP) is incomplete without mentioning two common side effects of this treatment; Peyronies Disease (PD) and penile shortening. PD, for which there is no satisfactory treatment, results from formation of penile scar tissue, makes intercourse difficult or impossible and usually causes loss of penile length and girth. (Penile shortening may also occur independent of PD). In the July 2008 edition of Medical News Today, it was reported that almost 20% of men developed PD after removal of their prostate. In a recent study, men who underwent a RP (whether robotically assisted or open) were woefully ignorant of these side effects, but those in the robotically assisted category had the most unrealistic expectations.
When I developed PD, I was unaware that a disease like this even existed. In frustration, I started an informational website, www.curepeyronies.net. Every email I get describes a man in a desperate situation with nowhere to turn. Urologists must do a better job of informing their patients of these common side effects so they will be able to give informed consent before undergoing surgery.
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