Funktionelle Ergebnisse und Komplikationen nach radikaler Prostatovesikulektomie in einem Krankenhaus der Maximalversorgung
Abstract
The functional outcome after radical prostatectomy is extremely heterogeneous in literature. Apart from that it is important to have knowledge about these results and the perioperative complications in any clinic as they influence the patients‘ quality of life. This is especially important in a teaching hospital with different experiences of different surgeons.
In our hospital 6 surgeons performed 1407 radical prostatectomys from 2008 to 2018. Bilateral nerve-sparing surgery was performed in 24.3%, unilateral surgery in 15.6%, 60.1% had a non-nerve-sparing operation. For the evaluation of the functional outcome the IIEF-5 (international index of erectile function-5) questionnaire and the amount of pads per 24 hours have been analysed preoperative and 3 to 6 months, 1 and 2 years after surgery.
Two years postoperative 902 (88.9%) patients needed 0-1 pads, 62 (6.1%) patients needed 2 pads and 52 (5.0%) patients needed 3 or more pads. The number of pads differed statistically significant depending on nerve-sparing or non-nervesparing surgery (p <0,00005), the average of pads was 0.68 in non-nerve-sparing, 0.59 in unilateral and 0.39 pads per 24 hours in bilateral nerve-sparing operation two years after surgery.
Of patients with a preoperative IIEF-score of 22 or higher after bilateral nervesparing surgery 43 to 73% reported an IIEF of 15 or higher in dependence of their age (average 51%); after unilateral nerve-sparing IIEF of 15 and higher was found in between 0 and 80% of patients with preoperative IIEF of at least 22.
IIEF was 15 and higher in 47% of men with preoperative IIEF of 15 and higher when performing bilateral nerve-sparing technique, 39% when performing nervesparing operation (uni- and bilateral). Furthermore the performing surgeon has to be considered in affecting postoperative erectile function.
The results confirm that continence rate even two years after surgery is significantly better in patients with nerve-sparing procedures. According to this, in patients with preoperative erectile dysfunction nerve-sparing technique should be considered if oncologically justifiable. Although the functional results, especially what erectile function is concerned, differs depending on the surgeon’s experience the results are comparable with literature and suggesting even in teaching hospitals with less experienced surgeons acceptable results can be achieved.
Perioperative complications in this collective are comparable with the complication rates found in literature. The complication reported the most is an infection of the lower urinary tract, classified as Clavien-Dindo II. Severe complications, corresponding Clavien-Dindo IIIb to V, were observed in 7,46% of the patients.
Review
Metadata
Contributors
Supervisor:
Dates
Issued: 2026-01-07
Faculty
FB20:Medizin
Language
de
Keywords
ProstatektomieKontinenzPotenzKomplikationenProstatakrebsProstatakarzinomProstatovesikulektomieerektile DysfunktionInkontinenz
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Dankert, Dorothe: Funktionelle Ergebnisse und Komplikationen nach radikaler Prostatovesikulektomie in einem Krankenhaus der Maximalversorgung. : 2026-01-07.
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This item has been published with the following license: In Copyright