Minimally invasive prostate surgery enhances risk of ED

The non invasive types of surgeries are normally preferred by majority of the prostate cancer patients for the reason that they typically lead to shorter hospital stays. However, the findings of a new study suggest that the associated complications may offset this advantage.

Non invasive surgery not superior
For the purpose of the study, Hu and his team of researchers analyzed the medical conditions of 1,938 men who had undergone minimally invasive radical prostatectomy (procedure in which the prostate gland is removed) and compared it with the outcomes for 6,899 men who underwent the traditional open radical prostatectomy.

The findings of the 18-month study revealed that men who had minimally invasive surgery had the advantage of a shorter hospital stay, were less likely to receive transfusions and ran a lower risk of respiratory complications. On the flip side, these patients experienced more urinary and genital complications. The death rates did not differ between the two groups.

"There has been rapid adoption of minimally invasive radical prostatectomy; however, outcomes have not been superior. We found men undergoing minimally invasive versus open surgery were more likely to have a diagnosis of incontinence and erectile dysfunction," said Dr. Jim C. Hu, the lead author of the paper, from Brigham and Women's Hospital in Boston.

Reactions from experts
The minimally invasive surgery has shown rapid acceptance since the introduction and heavy marketing of robot-assisted surgery. Hospitals advertise the systems on the grounds of being less traumatic and less painful. Less blood loss, lower risk of infection and lesser pain are the other touted benefits.

However, critics question the efficacy, need and use of this technique.

Dr. Herbert Lepor, chairman of the department of urology at NYU Langone Medical Center questioned, "All these claims that are driving robotics are not based on any credible evidence. We have to ask, how is this technology impacting our healthcare delivery? It has increased costs, and what have we gained? It looks like we are going backward in the most important clinical outcomes."

Lepor, who was not involved with the present study, is an avid supporter of open radical prostatectomy. He opines that the most relevant aspects that drive satisfaction in such surgeries are continence, erections and disease recurrence. Getting discharge a few days earlier or not having the need for a transfusion does not really matter at the end of the day.

Ryan Rhodes, marketing director for Intuitive Surgical, disputed the findings.

"There have been over 800 papers published in peer reviewed journals talking about the outcomes of radical prostatectomy. The majority of these were favorable," Rhodes said.