ORLANDO—Prostate cancer patients who undergo minimally invasive radical prostatectomy (MIRP) by surgeons who have converted from the open approach have a higher risk of erectile dysfunction (ED) than patients who undergo MIRP by surgeons who have used this procedure exclusively, researchers reported at the American Urological Association 2014 annual meeting.
Christopher Anderson, MD, and colleagues at Memorial Sloan-Kettering Cancer Center in New York, analyzed data from the Surveillance, Epidemiology and End Results (SEER)-Medicare dataset, identifying all surgeons who performed radical prostatectomies from 2002-2008.
Surgeons were classified as “converters” if they performed open radical prostatectomy (ORP) before their first MIRP, or as “de novo” if they had not. The researchers looked at a cohort of men aged 66 years or older and had received MIRP from 2003-2008.
In total, the investigators found 450 converters who performed 65% of all MIRPs, and 300 de novo surgeons who performed 35%. All converters had treated their patients with MIRP as of 2008, up from 50% in 2003. In a 3-year follow-up, the researchers found no difference in secondary cancer treatment or complications such as incontinence or bladder outlet obstruction. Patients treated by converters, however, had a 48% increased likelihood of ED.
“Converters may have had a different intensity of MIRP training than de novo surgeons, translating to variations in their patients’ functional outcomes,” the authors concluded.