To elucidate the effect of a nerve sparing (NS) procedure on patients’ urinary function (UF) and quality of life (QOL) after robot-assisted radical prostatectomy (RARP) in 3 years.

The participants in this study were 116 consecutive patients who underwent RARP. These patients were categorized into bilateral NS (Group 1), unilateral/partial NS (Group 2), unilateral/non NS (Group 3), bilateral partial NS (Group 4), partial/non NS (Group 5) and bilateral non NS (Group 6). The International Prostate Symptom Score (IPSS), QOL index and number of pads were evaluated before and 1, 3, 6, 9, 12, 18, 24, 36 months after RARP.

Baseline characteristics and perioperative outcomes are presented in Table 1. In Group 1 – 4, the total IPSS score was decreased 3 months after RARP and was stable until the 36 months. Groups 1 was significant difference between Group 5 and 6. The QOL index was decreased in all Groups 12 months after RARP and was stable until the 36 months. The changes in the values of QOL index from baseline was significantly decreased in Group 1 and 2 compared with the remaining Groups (Figure 1). Patients of Groups 1, 2 and 3 achieved 0 pads, while the other three Groups didn’t achieve 0 pads 24 months after RARP. Overall, there were no significant differences among the Groups. After 24 months, urinary continence didn’t improve (Table 1).

Our data may suggest that UF and QOL may not be improved 12 to 24 months post-RARP. The NS procedure in RARP may improve the QOL and UF. Group 1 and 2 had almost the same tendency. About Group 4, in changes in the IPSS total score from baseline, there was significant difference between Group 5 and 6.

In this study, NS procedure in RARP has the possibility to improve UF like previous studies. Our data may suggest that not only NS, partial NS may contribute to the improvement of UF.