Minimally Invasive vs. Open Radical Prostatectomy

Researchers find the minimally invasive approach results in a higher rate of genitourinary complications, incontinence and erectile dysfunction.

Boston, MA, November 13, 2009 --( Rates of minimally invasive radical prostatectomy (MIRP) for men with prostate cancer have increased nearly five-fold in the years from 2001 to 2006 despite the lack of scientific evidence that MIRP is superior to the traditional, open retropubic radical prostatectomy approach (RRP). New research from Brigham and Women's Hospital (BWH) shows that while MIRP results in shorter hospital stays, it does not result in fewer complications overall. These findings are published in the October 14, 2009 issue of the Journal of the American Medical Association.

"There are advantages to each type of surgery," said Jim Hu, MD, a surgeon in the Urology Division at BWH and lead author of the paper. "Any man who is making the decision to undergo RRP or MIRP should talk with his surgeon about their level of experience performing each type of surgery and what the outcomes are."

Researchers compared tumor registry and Medicare linked data from nearly 9,000 men with prostate cancer who underwent either MIRP or RRP from 2003-2007 for various outcomes. They found that men who underwent MIRP experienced shorter hospital stays, were less likely to need a blood transfusion, had less post-operative respiratory complications and less anastomic stricture. However, these men also had more genitourinary complications, were more likely to be diagnosed with incontinence and erectile dysfunction. The need for additional cancer therapy did not differ by surgical approach.

Researchers note that surgeons have been performing RRP for approximately 30 years whereas MIRP has only been an option for the past 8 years and that the differences in outcomes may be related to the technical skill of the surgeon.

"As with any new procedure, there is a learning curve," said Hu. "This finding is based on an average of the outcomes of many surgeries performed by many different surgeons with different skill levels throughout the country."

This research was funded by a Department of Defense Prostate Cancer Physician Training Award.

About Brigham and Women's Hospital:-
Brigham and Women's Hospital (BWH) is a 777-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare, an integrated health care delivery network. In July of 2008, the hospital opened the Carl J. and Ruth Shapiro Cardiovascular Center, the most advanced center of its kind. BWH is committed to excellence in patient care with expertise in virtually every specialty of medicine and surgery. The BWH medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in quality improvement and patient safety initiatives and its dedication to educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Biomedical Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, involving more than 860 physician-investigators and renowned biomedical scientists and faculty supported by more than $416 M in funding. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative. For more information about BWH, please visit

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