• To compare robotic-assisted radical prostatectomy (RALP), laparoscopic radical prostatectomy (LRP), and open radical prostatectomy (ORP) with respect to potency function at 2 years, after adjusting for known confounding variables measured at baseline. [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  

• To evaluate the recovery of continence after RALP, ORP or LRP. [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  

This study will prospectively assess clinical outcomes and changes from baseline in health-related quality of life (HRQOL) in men undergoing open, robotic-assisted, or laparoscopic radical prostatectomy. Open radical prostatectomy is a frequently performed treatment for patients with clinically localized (cT1-T3a) prostate cancer. The open technique stands as a benchmark against which all other treatments, including new surgical techniques, must be compared. Robotic-assisted and laparoscopic radical prostatectomy are considered an alternative surgical option for clinically localized prostate cancer. While these minimally invasive techniques are more frequently being performed in the United States, a detailed comparison of the open and laparoscopic techniques has not been performed. The relative risks and benefits of these surgical treatment options have not been explored in a contemporary group of patients treated at the same center by surgeons experienced in the open, robotic-assisted, or laparoscopic techniques.

This study will address this deficiency in that baseline and follow-up information will be collected prospectively in consecutive patients undergoing open, robotic-assisted, or laparoscopic radical prostatectomy.

While a prospective,randomized trial might be considered a more appropriate methodology to conduct such a comparative study, we have no baseline information, no guidelines to assess robotic-assisted or laparoscopic competence, and a lack of skilled laparoscopic pelvic surgeons to justify a lengthy and expensive trial. While results from our proposed study will not necessarily be generalizable to all surgeons and may very well be a comparison of surgeons rather than techniques, the results will provide an initial assessment comparing experts in the open, robotic-assisted, and laparoscopic techniques. To date, no such comparison has been published. To our knowledge, no other center has expert surgeons in these techniques where such a study would be feasible. Because open techniques have improved dramatically over the past several years, and because the baseline data to be recorded in this proposal is not currently collected, use of historical controls for open radical prostatectomy would be inappropriate.