Comparative Analysis of Robot-Assisted, Laparoscopic, and Open Radical Prostatectomy Regarding Lower Urinary Tract Symptoms

Abstract

Purpose: This study aims to assess lower urinary tract symptoms (LUTS) after radical prostatectomy (RP) and compare longitudinally the short-time LUTS changes of three techniques: robot-assisted RP (RARP), laparoscopic RP (LRP), and open RP (ORP). Materials and Methods: We reviewed prospectively the collected longitudinal data on the International Prostate Symptom Score (IPSS) from patients who performed RP for localized prostate cancer. One-year longitudinal data (preoperatively and at postoperative 3, 6, and 12 months) on IPSS were available for 322 patients. The number of patients was 231 for RARP, 42 for LRP, and 49 for ORP. LUTS was assessed on the basis of the IPSS and the IPSS quality of life (QOL) score. Results: The IPSS and IPSS related QOL scores were significantly improved over the baseline score not for the LRP and ORP but for the RARP. For patients with moderate to severe LUTS preoperatively, the RARP group immediately improved in terms of preoperative LUTS differently from both LRP and ORP groups. Only RARP significantly improved in terms of voiding symptom composites (VSC) differently from both LRP and ORP procedures. However, none of the procedures changed in terms of storage symptom composites (SSC) longitudinally. Conclusions: The improvement of LUTS for RARP may contribute to the improvement of not only SSC but also VSC.