Differences in self-reported outcomes of open prostatectomy patients and robotic prostatectomy patients in an international web-based survey Peter ‘Kevin’ O’Shaughnessy a, b, * , Thomas A. Laws a , Carol Pinnock c, d, e , Judd W. Moul f, g , Adrian Esterman a a School of Nursing and Midwifery, University of South Australia, City East Campus, North Terrace, Adelaide, South Australia 5001, Australia b Royal Adelaide Hospital, Adelaide, South Australia, Australia c Urology Unit, Repatriation General Hospital, Daw Park, South Australia, Australia d School of Medicine, Flinders University, Adelaide, South Australia, Australia e Division of Surgery, Adelaide University, Adelaide, South Australia, Australia f Duke Prostate Center, Duke Cancer Institute, Durham, NC, USA g Division of Urology, Department of Surgery, Duke University, Durham, NC, USA Keywords: Radical prostatectomy Robotic prostatectomy Survey Outcomes Nursing Specialist Prostate Cancer Nurse abstract Objectives: To compare patient reported outcomes between robotic assisted surgery and non-robotic assisted surgery. Methods: This was an international web-based survey based on a qualitative research and literature review, an internet-based questionnaire was developed with approximately 70 items. The questionnaire included both closed and open-ended questions. Results: Responses were received from 193 men of whom 86 had received either open (OP) or robotic (RALP) surgery. A statistically significant (p ¼ 0.027), ranked analysis of covariance was found demon- strating higher recent distress in the robotic (RALP) surgery group. Although not statistically significant, there was a pattern of men having robotic (RALP) surgery reporting fewer urinary and bowel problems, but having a greater rate of sexual dysfunction. Conclusions: Men who opt for robotic surgery may have higher expectations for robotic (RALP) surgery, when these expectations are not fully met they may be less likely to accept the consequences of this major cancer surgery. Information regarding surgical choice needs to be tailored to ensure that men diagnosed with prostate cancer are fully informed of not only short term surgical and physical outcomes such as erectile dysfunction and incontinence, but also of potential issues with regards to masculinity, lifestyle and sexual health. Ó 2013 Published by Elsevier Ltd. Introduction Radical prostatectomy (RP) or removal of the prostate by surgery is the most frequently received treatment for localised prostate cancer in Australia, Europe and the United States of America (Cooperberg et al., 2004; Jemal et al., 2010; ACS, 2010; Chambers et al., 2008). Prostatectomy involves the removal of the entire prostate gland, seminal vesicles, sections of the vas deferens and in many cases the bladder neck (Walsh and Donker 2002; Rozet et al., 2004). There has been much recent discussion regarding the ben- efits of robotic assistance in prostate surgery (Chambers et al., 2008; Lowrance et al., 2010; Schroeck et al., 2012). There are two open (OP) types of surgery: the retropubic radical prostatectomy (RRP) and the radical perineal prostatectomy (RPP) as well as the laparoscopic radical (LRP) prostatectomy, the first laparoscopic surgery being performed in the early 1990’s (Schuessler et al., 1997; Rozet et al., 2007). Bolenz et al. (in press) detail how this minimally invasive alternate approach to the pre- vious open surgical approach is becoming standard practice. Robotic assisted laparoscopic radical prostatectomy (RALP) was introduced in the early 2000’s to provide surgeons with technical advantages, such as better magnification, computer elimination of tremor, and an end of wrist instrument with seven degrees of range * Corresponding author. E-mail addresses: kevin.o’shaughnessy@unisa.edu.au (P.‘Kevin’ O’Shaughnessy), Tom.Laws@unisa.edu.au (T.A. Laws), Carole.pinnock@health.sa.gov.au (C. Pinnock), judd.moul@duke.edu (J.W. Moul), Adrian.Esterman@unisa.edu.au (A. Esterman). Contents lists available at SciVerse ScienceDirect European Journal of Oncology Nursing journal homepage: www.elsevier.com/locate/ejon 1462-3889/$ e see front matter Ó 2013 Published by Elsevier Ltd. http://dx.doi.org/10.1016/j.ejon.2013.03.010 European Journal of Oncology Nursing 17 (2013) 775e780