STEP 4
Review The Medical Literature At Pub Med
Now I wanted to research the medical literature to review the most recently published studies.
So I went to the Pub Med web site and did searches on:
Prostate cancer AND watchful waiting;
Prostate cancer AND laparoscopic prostatectomy;
Prostate cancer AND robotic-assisted prostatectomy;
Prostate cancer AND seed implants;
Prostate cancer AND brachytherapy;
Here are abstracts from some of the most relevant articles I found. Note the dates on these papers. You can see how recent many of them are. (This chapter is being written in May 2006).
If you were to do the same search at the time you are reading this there will be even more current information available.
Here’s a study from one of the leading institutions specializing in the robotic-assisted procedure.
This study shows that the Veil of Aphrodite nerve-sparing robotic prostatectomy provides better recovery of sexual function at 1 year than in contemporary series from centers of excellence, without compromising cancer control and urinary function. So, this study is really commenting on the side effect profile one year after surgery.
Functional outcomes and oncological efficacy of Vattikuti Institute prostatectomy with Veil of Aphrodite nerve-sparing: an analysis of 154 consecutive patients.
Kaul S, Savera A, Badani K, Fumo M, Bhandari A, Menon M
Vattikuti Urology Institute, Detroit, MI 48202, USA. skaul1@hfhs.org
BJU Int. 2006 Mar;97(3):467-72.
OBJECTIVES: To report updated results, at 1 year of follow-up, of a modified nerve-sparing robotic radical prostatectomy that preserves the lateral prostatic fascia (Veil of Aphrodite). PATIENTS AND METHODS: From January to December 2003, 154 consecutive men had a Vattikuti Institute prostatectomy with Veil of Aphrodite nerve-sparing by one surgeon. A prospective database recorded patient demographics, intraoperative, peri-operative, and pathological variables. Peri-operative complications were recorded using the Clavien classification. Patients had serum prostate-specific antigen (PSA) levels measured every 3 months and self-administered the International Prostate Symptom Score and Sexual Health Inventory for Male questionnaires before and at 1 year after surgery. RESULTS: The men had a mean age of 57.4 years, a mean body mass index of 27.2 kg/m(2), and a mean PSA level before surgery of 5.11 ng/mL. The mean operative duration was 122 min. At 1 year, 96% of the men reported having had intercourse and 71% had recovered normal erectile function. One man had a Clavien grade II complication, 4.6% of men with organ-confined disease had positive surgical margins, and no patient had a PSA recurrence at 12 months; 97% of the men were continent at 1 year, and the median time to continence was 14 days. CONCLUSION: Veil of Aphrodite nerve-sparing surgery provides better recovery of sexual function at 1 year than in contemporary series from centers of excellence, without compromising cancer control and urinary function.
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