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Urinary incontinence and impotence are typical disturbances after radical prostatectomy. Although, several surgical methods are developed to decrease these disturbances, 8% and 50% of the patients suffer from permanent urinary incontinence and impotence, respectively.
Previously two studies have shown that endopelvic fascia preservation may decrease postoperative incontinence and impotence rates. Unfortunately these studies are retrospective decreasing their reliability.
The present study is prospective and randomized clinical trial. The investigators are going to randomize 180 patient to preservation and opening the endopelvic fascia groups. Functional and oncological results are followed up to 1 year after surgery.
180 patients going to radical prostatectomy as treatment of prostate cancer will be randomized 1:1 to two study arms: In the other arm endopelvic fascia are preserved during the operation, in the other arm the fascia are opened.
After the operation urinary continence and erection function are compared between the study arms. Additionally the investigators will study oncological outcomes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Preservation (endopelvic fascia) | Experimental | During robotic assisted laparoscopic radical prostatectomy endopelvic fascia are preserved. |
|
| Opening (endopelvic fascia) | Active Comparator | During robotic assisted laparoscopic radical prostatectomy endopelvic fascia are opened. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Preservation (endopelvic fascia) | Procedure | Robotic assisted radical prostatectomy with preserving of endopelvic fascia |
|
| Measure | Description | Time Frame |
|---|---|---|
| Urinary incontinence | EPIC-26 questionnaire preoperatively and 3 and 12 months after surgery | 1 year |
| Erectile function | EPIC-26 questionnaire preoperatively and 3 and 12 months after surgery | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Complications | Clavien-Dindo classification | 1 year |
| Oncologic results: positive surgical margin rate | Positive surgical margin rate as reported in pathological analysis of the removed prostate |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jarno Riikonen, MD | Tampere University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tampere University Hospital | Tampere | Finland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33358241 | Derived | Siltari A, Riikonen J, Murtola TJ. Preservation of Endopelvic Fascia: Effects on Postoperative Incontinence and Sexual Function - A Randomized Clinical Trial. J Sex Med. 2021 Feb;18(2):327-338. doi: 10.1016/j.jsxm.2020.11.003. Epub 2020 Dec 23. |
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| Opening (endopelvic fascia) | Procedure | Robotic assisted radical prostatectomy with opening of endopelvic fascia |
|
| 1 year |
| ID | Term |
|---|---|
| D011471 | Prostatic Neoplasms |
| D014549 | Urinary Incontinence |
| D007172 | Erectile Dysfunction |
| ID | Term |
|---|---|
| D005834 | Genital Neoplasms, Male |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D005832 | Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D011469 | Prostatic Diseases |
| D052801 | Male Urogenital Diseases |
| D014555 | Urination Disorders |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D059411 | Lower Urinary Tract Symptoms |
| D020924 | Urological Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D012735 | Sexual Dysfunction, Physiological |
| D020018 | Sexual Dysfunctions, Psychological |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D011309 | Preservation, Biological |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
| D008919 | Investigative Techniques |
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