Mixed Outcomes Seen for Less Invasive Prostate Surgery

-- Eric Metcalf

Tuesday, October 13, 2009

TUESDAY, Oct. 13 (HealthDay News) -- Although minimally invasive radical prostatectomy (MIRP) may be associated with some benefits compared to retropubic radical prostatectomy (RRP), it is also associated with more genitourinary complications, according to research published in the Oct. 14 issue of the Journal of the American Medical Association.

Jim C. Hu, M.D., of the Brigham and Women's Hospital in Boston, and colleagues analyzed data from 1,938 men with prostate cancer who underwent MIRP and 6,899 who underwent RRP between 2003 and 2007.

The researchers found that use of MIRP increased from 9.2 percent in 2003 to 43.2 percent in 2006 to 2007. MIRP was associated with a briefer stay (two days versus three days) and a lower likelihood of transfusion (2.7 versus 20.8 percent). Men undergoing MIRP also had lower rates of postoperative respiratory and miscellaneous surgical complications. Conversely, MIRP was also associated with higher risk of genitourinary complications (4.7 versus 2.1 percent), as well as diagnoses of incontinence and erectile dysfunction.

"In light of the mixed outcomes associated with MIRP, our finding that men of higher socioeconomic status opted for a high-technology alternative despite insufficient data demonstrating superiority over an established gold standard may be a reflection of a society and health care system enamored with new technology that increased direct and indirect health care costs but had yet to uniformly realize marketed or potential benefits during early adoption," the authors conclude.

A co-author reported a financial relationship with the Foundation for Informed Medical Decision Making.

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Specialties Cardiology
Diabetes & Endocrinology
Internal Medicine
Family Practice

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