Adverse effects of robotic-assisted laparoscopic versus open retropubic radical prostatectomy among a nationwide random sample of medicare-age men
Open accessAbstract
Purpose: Robotic-assisted laparoscopic radical prostatectomy is eclipsing open radical prostatectomy among men with clinically localized prostate cancer. The objective of this study was to compare the risks of problems with continence and sexual function following these procedures among Medicare-age men. Patients and Methods: A population-based random sample was drawn from the 20% Medicare claims files for August 1, 2008, through December 31, 2008. Participants had hospital and physician claims for radical prostatectomy and diagnostic codes for prostate cancer and reported undergoing either a robotic or open surgery. They received a mail survey that included self-ratings of problems with continence and sexual function a median of 14 months postoperatively. Results: Completed surveys were obtained from 685 (86%) of 797 eligible participants, and 406 and 220 patients reported having had robotic or open surgery, respectively. Overall, 189 (31.1%; 95% CI, 27.5% to 34.8%) of 607 men reported having a moderate or big problem with continence, and 522 (88.0%; 95% CI, 85.4% to 90.6%) of 593 men reported having a moderate or big problem with sexual function. In logistic regression models predicting the log odds of a moderate or big problem with postoperative continence and adjusting for age and educational level, robotic prostatectomy was associated with a nonsignificant trend toward greater problems with continence (odds ratio [OR] 1.41; 95% CI, 0.97 to 2.05). Robotic prostatectomy was not associated with greater problems with sexual function (OR, 0.87; 95% CI, 0.51 to 1.49). Conclusion: Risks of problems with continence and sexual function are high after both procedures. Medicare-age men should not expect fewer adverse effects following robotic prostatectomy.
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The loss of sexual intimacy can be devastating for partners, relationship satisfaction, health outcomes, mental health outcomes, and overall quality of life.
“The loss of sexual intimacy can be devastating for partners, relationship satisfaction, health outcomes, mental health outcomes, and overall QoL.4, 5, 6”
From Preliminary Development of a Mindfulness-Based Group Therapy to Expand Couples’ Sexual Intimacy after Prostate Cancer: A Mixed Methods Approach (2021) · cites this paper as [4]
Table 3 (page not provided) shows that men reporting greater problems with sexual function also reported poorer overall health. The paper does not establish that loss of sexual intimacy causes these outcomes, and it does not assess partners, relationship satisfaction, or quality of life; the mental-health difference in Table 3 was not statistically significant. (LLM, conf=0.84)
Experimental — accuracy not yet measuredSide effects of prostate cancer treatments impact the sexual lives of men and their partners, including erectile dysfunction, climacturia, anorgasmia, urinary or fecal incontinence, penile shortening, and/or loss of sexual desire.
“Side effects of PC treatments impact the sexual lives of men and their partners, including erectile dysfunction, climacturia (loss of urine with ejaculation), anorgasmia (inability to reach orgasm), urinary or fecal incontinence, penile shortening, and/or loss of sexual desire.1,3, 4, 5, 6,8,12”
From Preliminary Development of a Mindfulness-Based Group Therapy to Expand Couples’ Sexual Intimacy after Prostate Cancer: A Mixed Methods Approach (2021) · cites this paper as [4]
The Patients and Methods section asks men about urine leakage and sexual-function problems, including erections; the Results report problems with both outcomes after prostatectomy. The paper does not assess effects on partners or identify climacturia, anorgasmia, fecal incontinence, penile shortening, or loss of sexual desire. Its findings also concern prostatectomy in Medicare-age men, not prostate cancer treatments generally. Page numbers were not available in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredSide effects of prostate cancer treatments negatively impact patient and partner quality of life.
“These side effects negatively impact patient and partner quality of life (QoL),4, 5, 6”
From Preliminary Development of a Mindfulness-Based Group Therapy to Expand Couples’ Sexual Intimacy after Prostate Cancer: A Mixed Methods Approach (2021) · cites this paper as [4]
The Results report that many Medicare-age men rated postoperative continence or sexual-function effects as moderate or big problems, supporting an adverse impact on patients. The paper does not report partners’ quality of life, and its patient findings concern radical prostatectomy rather than prostate cancer treatments generally. (LLM, conf=0.86)
Experimental — accuracy not yet measured
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- Authors
- Barry, M. J., Gallagher, P. M., Skinner, J. S., & Fowler, F. J.
- Affiliations
- Dartmouth College (US)
- Venue
- Journal of Clinical Oncology
- Published
- 2012-02-10
- Volume
- 30
- Issue
- 5
- Pages
- 513-518
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- PMC
- PMC3295553
- OpenAlex
- W2155785809
- Semantic Scholar
- e11d7648e8c9a20e73bbf236089f2d223c169e1e
- Cited by
- 177
- References
- 33
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 6 · 2023: 6 · 2022: 4 · 2021: 6 · 2020: 10 · 2019: 4 · 2018: 7 · 2017: 19 · 2016: 16 · 2015: 23 · 2014: 22 · 2013: 25 · 2012: 24
- FWCI
- 24.23
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Oncology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (AG019783-08, AG019783, P01AG019783)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Treatment and Research
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Keywords
- robot-assisted radical prostatectomy, open radical prostatectomy, prostate cancer, postoperative urinary continence, sexual function, adverse effects
- MeSH terms
- Aged, Decision Making, Medicare, Health Status, Humans, Erectile Dysfunction, Male, Mental Health, Laparoscopy, Prostatectomy, Prostatic Neoplasms, Surveys and Questionnaires, Robotics, United States, Urinary Incontinence, Logistic Models, Odds Ratio, Treatment Outcome
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