08 October 2010

October 2010- A. E. Canda and colleagues of Ankara, Turkey won the 2nd Prize for Best Abstract from Karl Storz during the 6th South Eastern European Meeting (SEEM) held last weekend in Istanbul, Turkey. The abstract of their study appears below:

Erectile dysfunction is a complication of radical prostatectomy which has a significant impact on the patients’ quality of life. Penile erection is a neurovascular phenomenon under hormonal control. Accessory pudendal arteries (APAs) are suggested to have an impact on erectile function.

Between February 2009 and February 2010, the investigators performed 70 robot assisted laparoscopic radical prostatectomy (RALRP) procedures at their institution. Mean patient age, mean American Society of Anesthesiologists (ASA) score, mean serum prostate specific antigen (PSA), mean body mass index (BMI) and mean preoperative International Index of Erectile Function scores (IIEFS) were; 62+/-6 years, 2, 8.5+/-5.9 (ng/mL), 27.5+/-8.9 (kg/m2) and 35.4+/-23.3, respectively.

The results showed that the researchers detected 15 APAs (21.4%) in our series all of which were preserved. Concerning patients with APA, mean patient age was 62±4 years and mean BMI was 26.9±2.7 kg/m2. In all but two patients, bilateral nerve sparing RALRP was performed. Locations of the APAs were as follows: right (n=7), left (n=6) and bilateral (n=2).

Ten patients had co-morbidities including hypertension, diabetes, hyperlipidemia or cardiac disease. Preoperative erectile status due to IIEFS were as follows: severe dysfunction (IIEFS<7, n=2), moderate dysfunction (IIEFS=7-12, n=3), mild to moderate dysfunction IIEFS=13-18, n=1), mild dysfunction (IIEFS=19-24, n=1) and no dysfunction (IIEFS>25, n=8). All patients were administered oral PDE-5 inhibitors postoperatively. Mean IIEFS were as follows on follow-up; 1st-month: 5 (n=15), 3rd-month: 6.5±3.3 (n=14), 6th-month: 11.5+/-6.7 (n=9) and 1st-year: 32.5+/-31.8 (n=2).

“We suggest preserving APAs whenever possible during performing RALRP which might improve quality of erections in the postoperative course,” the researchers concluded.

“Advantages of the surgical robotic system such as providing three dimensional
vision with magnification, increased freedom of the hand maneuvers of the robotic arms and instruments with filtered tremor seem to provide the console surgeon to easily recognize and preserve APAs during the surgery,” they added.

Source: A. E. Canda, et al., “Preservation of accessory pudendal arteries in robot-assisted laparoscopic radical prostatectomy,” 2nd Prize Best Abstract Karl Storz, Poster Session, 6th South Eastern European Meeting (SEEM), 1-2 October 2010, Istanbul, Turkey.

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