Assessment of the Impact of Pentafecta Parameters Affecting the Quality of Life of Patients Undergoing Laparoscopic Radical Prostatectomy
Abstract
:1. Introduction
2. Materials and Methods
- −
- Sexually active men, who scored at least 12 points in the IIEF-5 male questionnaire;
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- Qualifying for the procedure with the sparing of nerve-nerve bundles by the urologist performing the surgery. Qualification was performed in accordance with the guidelines of the European Society of Urology and was undertaken on the basis of clinical data from a physical examination and radiological examinations.
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
Patient’s nutritional status | Skinny 1 | Slim 2 | Average weight 3 | Obese 4 | Very obese 5 |
Construction of the pelvis | Very easy access to the prostate 1 | Easy access to the prostate 2 | Typical access to the prostate 3 | Difficult access to the prostate 4 | Very difficult access to the prostate 5 |
Conditions for the preparation of connective tissue | Very susceptible tissues 1 | Susceptible tissues 2 | Typical conditions for tissue preparation 3 | Tissues insensitive, dense 4 | Very insusceptible tissues, scarred numerous adhesions 5 |
Conditions for the preparation and dissection of the prostate | Very clear structures, Very clear layers 1 | Clear structures, clear layers 2 | Typical prostate anatomy, marked layers 3 | Slight infiltration, no clear layers 4 | Massive infiltrates, no anatomical layers 5 |
Conditions for restoring the continuity of the urinary tract | Preserved bladder neck and urethra, tight anastomosis. No difficulties 1 | Preserved bladder neck and urethra, tight anastomosis. Slight difficulties 2 | Preserved bladder neck and urethra, tight anastomosis 3 | Neck or bobbin not preserved, need to add additional stitches 4 | Neck and coil not preserved, need to recreate the anastomosis again 5 |
Length of surgery | |||||
Blood-loss | |||||
Name of Surgeon |
Appendix B
Criteria Z1 | Criteria Z2 | Criteria Z3 | ||
Complete preservation of the bladder neck | Partial preservation of the bladder neck | Failure to preserve the bladder neck | ||
Performing vesicourethral anastomosis with the use of six sutures | Perform vesicourethral anastomosis using a different number of sutures than six | The need for additional stitches on the bladder | ||
Positive leak test | Positive leak test | Negative leak test | ||
Other deviations from the pattern | ||||
In criteria Z1, all parameters must be met. The presence of one trait from a group of a higher degree causes a shift to that group. |
Appendix C
Unacceptable, requires medical attention 1 | Very bad, need medical help 2 | Significant ailments, I need a regular medical care 3 | Moderate ailments, sometimes I seek for medical care 4 | Minimal complaints, however, does not need any medical attention 5 | No symptoms, no need for medical attention 6 |
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Characteristic | Results (n = 131) |
---|---|
Number of patients recruited | 237 |
Number of patients followed | 217 |
Number of patients meeting the inclusion criteria for the study | 131 |
Age, mean (SD) | 62.83 (±5.43) |
BMI, mean (SD) | 27.80 (±3.44) |
Charlson scale, median | 2 (0–3) |
Positive family history (%) | 10 (7.63%) |
Education: | |
Basic, vocational (%) | 30 (22.90%) |
Technical secondary (%) | 59 (45.03%) |
Higher, Bachelor (%) | 42 (32.06%) |
Characteristic | Results (n = 131) | Characteristic | Results (n = 131) |
---|---|---|---|
PSA, mean (SD) | 9.43 (±5.96) | Gleason/ISUP: | |
PSA, median (min-maks) | 7.6 (3.2–43.6) | 1 (%) | 90 (68.70%) |
Clinical advancement: | 2 (%) | 27 (20.61%) | |
cT1c (%) | 48 (36.64%) | 3 (%) | 8 (6.10%) |
cT2a (%) | 27 (20.61%) | 4 (%) | 6 (4.58%) |
cT2b (%) | 38 (29.00%) | Risk group d’Amico: | |
cT2c (%) | 15 (11.45%) | Low | 38 (29.00%) |
cT3a (%) | 1 (0.76%) | Intermediate | 65 (49.61%) |
cT3b (%) | 2 (1.52) | High | 28 (21.37%) |
Amount of material seized, median (Extremes) | 42% (8–75%) | Waiting time from biopsy to prostatectomy in days, mean (SD) | 138.79 (±190.61) |
IIEF-5, mean (SD) | 20.57 (±3.99) | IIEF-5, median (Ekstrema) | 21 (18–25) |
Component of Pentafecta | 6 Weeks | 3 Months | 6 Months | 12 Months | |
---|---|---|---|---|---|
Erectile function | 51 | 65 | 63 | 57 | |
Urinary continence | 50 | 37 | 26 | 26 | |
Surgical margins | 3 | 2 | 1 | 1 | |
Biochemical remission | 14 | 18 | 21 | 25 | |
Complications | 8 | 6 | 4 | 3 | |
Other | 3 | 1 | 2 | 2 | |
No complaints | 2 | 2 | 14 | 17 |
Component of Pentafecta | 6 Weeks | 3 Months | 6 Months | 12 Months | |
---|---|---|---|---|---|
Erectile function | 4.52 | 4.78 | 4.95 | 4.96 | |
Urinary continence | 3.82 | 4.27 | 4.19 | 4.38 | |
Surgical margins | 4.33 | 4 | 5 | 5 | |
Biochemical remission | 4.14 | 4.38 | 4.38 | 4.48 | |
Complications | 3.5 | 4 | 4.5 | 5.33 | |
Other | 4.33 | 4 | 3.5 | 4 | |
No complaints | 5.5 | 6 | 5.5 | 5.74 |
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Wojtarowicz, M.; Przepiera, A.; Lemiński, A.; Gołąb, A.; Słojewski, M. Assessment of the Impact of Pentafecta Parameters Affecting the Quality of Life of Patients Undergoing Laparoscopic Radical Prostatectomy. Int. J. Environ. Res. Public Health 2023, 20, 944. https://doi.org/10.3390/ijerph20020944
Wojtarowicz M, Przepiera A, Lemiński A, Gołąb A, Słojewski M. Assessment of the Impact of Pentafecta Parameters Affecting the Quality of Life of Patients Undergoing Laparoscopic Radical Prostatectomy. International Journal of Environmental Research and Public Health. 2023; 20(2):944. https://doi.org/10.3390/ijerph20020944
Chicago/Turabian StyleWojtarowicz, Mateusz, Adam Przepiera, Artur Lemiński, Adam Gołąb, and Marcin Słojewski. 2023. "Assessment of the Impact of Pentafecta Parameters Affecting the Quality of Life of Patients Undergoing Laparoscopic Radical Prostatectomy" International Journal of Environmental Research and Public Health 20, no. 2: 944. https://doi.org/10.3390/ijerph20020944