Robotic Prostate Surgery May Mean Big Trade-off

CARLA K. JOHNSON

CHICAGO (AP) — A new study suggests less-invasive keyhole surgery for prostate cancer may mean a higher risk for lasting incontinence and impotence when compared with traditional surgery.

The results add to confusion around prostate cancer treatments, which sometimes lead to urinary and sexual problems. It's not clear that either kind of surgery is superior to radiation alone or watchful waiting, which means simply monitoring the prostate for changes.

Laparoscopic, or keyhole, surgery is increasingly chosen by men having a cancerous prostate removed. And often it involves the highly marketed da Vinci robotics system. Da Vinci's popularity has been rising even though there's never been a rigorous head-to-head comparison between it and standard surgery.

"There's been a rapid adoption of this relatively new technique," said the study's lead author Dr. Jim Hu of Brigham and Women's Hospital in Boston.

For the study, appearing in Wednesday's Journal of the American Medical Association, researchers analyzed Medicare data for nearly 9,000 prostate cancer patients who had surgical treatment from 2003-07. Of those, 1,938 patients had minimally invasive surgery and 6,899 patients had standard surgery. The data did not indicate how many of the less invasive cases involved robotics.