Laparoscopic Radical Prostatectomy Not that Great

One would think minimally invasive prostatectomy would have fewer side effects – in the postop period they do, but not in the long term…

JAMA. 2009 Oct 14;302(14):1557-64.
Comparative effectiveness of minimally invasive vs open radical prostatectomy.
Hu JC, Gu X, Lipsitz SR, Barry MJ, D’Amico AV, Weinberg AC, Keating NL.
free article here

The laparoscopic was with or without computer assistance  – 1,938 caseds

Other prostatectomy was the open retropubic radical prostatectomy – 6,899 cases

Incontinence – 15.9% with laparoscopic versus 12.2% open

Erectile dysfunction – 26.8% laparoscopic verus 19.2% open

Comment – To be fair, there is a  150 to 250 case learning curve with these procedures so those with much experience might have better results. However, from the looks of it, there is little advantage to the laparoscopic procedure longterm.

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