Introduction

To prospectively evaluate the safety and efficacy of perineal hydrodissection in robot assisted nervesparing prostatectomy in a randomized, controlled trial in patient scheduled for nerve sparing, robot assisted prostatectomy_x000D_

Methods

Patients were randomized for perineal, ultrasound guided hydrodissection(HD) prior to radical prostatectomy and compared to standard treatment(ST). Perioperative parameters were assessed and included: erectile function (IIEF5-score), reported grade of erection, ability for sexual intercourse, continence, TNM stage and Gleason of prostatectomy specimen, blood loss and time for surgery, PSA. Follow-up was done every 3 months, including erectile function (IIEF5-score), reported grade of erection, ability for sexual intercourse, continence, PSA._x000D_

Results

21 patients were enrolled to this prospective study, 10 for ST and 11 for HD. Both groups showed comparable demographic and preoperative oncological data. Blood loss and time for surgery did not differ significantly. HD resulted in 66% (4/6) rate of positive surgical margins(PSM) in pT3 tumors vs. 50% in ST (1/2;p=0.67). Follow-up revealed higher IIEF scores, better ability for sexual intercourse and early continence in HD. _x000D_

Conclusions

Perineal hydrodissection should not be performed in pT3 tumors. Although it can increase postoperative erectile function after radical prostatectomy, careful patient selection is needed to avoid PSM_x000D_

Funding

none