Sci Forschen Open HUB for Scientific Research Journal of Surgery: Open Access ISSN 2470-0991 | Open Access J Surg Open Access | JSOA 1 RESEARCH ARTICLE Which Factors Afect Short-Term Urinary Contnence and Erectle Functon Recovery Following Robotc-Assisted Radical Prostatectomies (RARP)?-A Retrospectve Cohort Study Reyan Saghir 1, *, Francesca Kum 2 , Noman Saghir 3 , Cecilia Bosco 4 , Mieke Van Hemelrijck 4 , Prokar Dasgupta 5 , Paul Cathcart 5 , Christan Brown 5 , Rick Popert 5 , Kathie Wong 2 , Lorenzo Marconi 6 , and Ben Challacombe 5 1 Foundaton Year Doctor, GKT School of Medicine, King’s College London, Hodgkin Building, Newcomen St, London SE1 1UL, United Kingdom 2 Urology Registrar, Guy’s Hospital Urology Department, Great Maze Pond, London SE1 9RT, United Kingdom 3 Plastcs Core Trainee, Pinderfelds General Hospital, Aberford Road, Wakefeld, WF1 4DG, United Kingdom 4 Division of Cancer Studies, Cancer Epidemiology Group, King’s College London, London, United Kingdom 5 Consultant Urological Surgeon, Guy’s Hospital Urology Department, Great Maze Pond, London SE1 9RT, United Kingdom 6 Robotc Fellow, Guy’s Hospital Urology Department, Great Maze Pond, London SE1 9RT, United Kingdom *Corresponding author: Reyan Saghir, Foundaton Year Doctor, GKT School of Medicine, King’s College London, Hodgkin Building, Newcomen St, London SE1 1UL, United Kingdom, E-mail: reyansaghir@gmail.com Received: 03 May, 2021 | Accepted: 05 May, 2021 | Published: 10 May, 2021 Volume 7 - Issue 3 Citaton: Saghir R, Kum F, Saghir N, Bosco C, Van Hemelrijck M, et al. (2021) Which Factors Afect Short-Term Urinary Contnence and Erectle Functon Recovery Following Robotc-Assisted Radical Prostatectomies (RARP)?-A Retrospectve Cohort Study. J Surg Open Access 7(3): dx.doi. org/10.16966/2470-0991.238 Copyright: © 2021 Saghir R, et al. This is an open-access artcle distributed under the terms of the Creatve Commons Atributon License, which permits unrestricted use, distributon, and reproducton in any medium, provided the original author and source are credited. Abstract Introducton: To evaluate peri-operatve variables in men undergoing Robotc-Assisted Radical Prostatectomy (RARP) and their relatonship with short-term outcomes at a tertary referral centre. These variables can inform surgical planning and intra-operatve management to improve patent outcomes. Patents and Methods: A retrospectve analysis of consecutve 331 RARPs over a 16-month period performed by fve surgeons was conducted. Primary endpoints included undetectable PSA at 6 weeks, urinary contnence defned as 0-1 pad use for security leakage at 6 months, and erectle functon defned as ability to have intercourse with or without PDE-5 inhibitors, pump or intercavernosal injectons at 6 months. Models for multple logistc regression analysis were fted for predicton of each of the three endpoints. Results: Using multple logistc regression analysis increased postoperatve PSA levels were found signifcantly associated to; increased preoperatve PSA levels (Odds Rato [OR]=1.05, 95% Confdence Interval [CI]=1.01-1.09, p=0.01), presence of positve surgical margins less than 3mm compared to negatve margins (OR=4.7, 95% CI=1.87-11.81, p=0.00) and presence of metastatc lymph nodes vs. benign (OR=4.74, 95% CI=0.96-23.99, p=0.05), whilst unilateral and bilateral nerve sparing compared to non-nerve sparing were signifcantly associated to undetectable levels of PSA postoperatvely respectvely (OR=0.37 and 0.3, 95% CI=0.15-0.91 and 0.12-0.71, p=0.03 and 0.01). Contnence outcomes were found to be signifcantly associated with increasing age (OR=1.04, 95% CI=1.01-1.08, p=0.02) and difering amongst the operatng consultants (OR=0.33, 95% CI=0.13-0.82, p=0.02), whilst erectle dysfuncton was also found to be signifcantly associated with increasing age (OR=1.78, CI=1.49-2.28, p=0.00). Conclusion: The level of nerve sparing performed needs to be considered in relaton to the presence of positve surgical margins remaining as this can signifcantly impact postoperatve PSA levels in the short-term and reduce the chances of a biochemical cure. The interoperator variability amongst operatng consultants in relaton to contnence outcomes proves interestng and needs further investgaton. Keywords: Robotc assisted radical prostatectomy; PSA; Contnence; Erectle dysfuncton; RARP; Prostate cancer limited PLND refers to only the lymph nodes surrounding and in close association to the prostate found in the external iliac and obturator fossa areas, meanwhile extended PLND remove nodes further away including hypogastric, pre-sacral and pre-sciatic regions [2]. Development of the DaVinci (Intuitive®) surgical system and preliminary trialling of its application in a urological setting led to the frst documented RARP occurring in early 2000 [1,3,4]. Following this, Introduction Robotic-Assisted Radical Prostatectomy (RARP) is currently a gold standard treatment for localised prostate cancer [1]. Variations in prostatectomy technique include nerve-sparing, limited or extended Pelvic Lymph Node Dissection (PLND). During nerve-sparing, the closely associated neurovascular bundles are preserved to allow for spontaneous penile erections to be maintained postoperatively. A