Symptomatic response to laparoscopic prostatectomy

Symptomatic response to laparoscopic prostatectomy

A new paper offers a preliminary look at the symptomatic response to laparoscopic prostatectomy, a minimally invasive procedure commonly done for prostate cancer, in patients with severely symptomatic, treatment-refractory chronic prostatitis/chronic pelvic pain syndrome.

The findings suggest that in some cases, laparoscopic prostatectomy may offer symptomatic relief for some of the most difficult and severe cases. You can download the paper if you click here.
In brief, using the Chronic Prostatitis Symptom Index (CPSI) as its outcome measure, researchers are tracking patients with severely symptomatic chronic prostatitis. The enrolled patients have failed numerous medical, surgical, and complementary treatments

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The mean age of the patients who are described in the newly published paper is 48.5 years; they had been ill for up to 31 years and had each consulted up to 20 doctors and other health practitioners before enrolling. They appear to be among the sickest and longest suffering prostatitis patients described in the medical literature.

All patients described in the new publication reported resolution of their prostatitis. This subjective assessment was paralleled by the CPSI symptom trends: before entering the study, mean CPSI score was 35 and by one year after surgery it was 7.5. Individual response patterns over the first year after surgery are shown in the figure below.


The new findings seem to set the therapeutic potential of laparoscopic prostatectomy apart from that of other treatments. However, any decision to have laparoscopic prostatectomy should be tempered by the recognition that these are very preliminary observations, the uniformity of response seen in these patients is unlikely to persist, the durability of symptomatic relief beyond a year is unknown, and the general likelihood of response has not been established.
Furthermore, as reviewed in the paper, patients with chronic prostatitis have many other treatment options. Any decision for laparoscopic prostatectomy must take this into account along with the knowledge that laparoscopic prostatectomy causes infertility and is associated with risk of erectile dysfunction, urinary incontinence, and others.

  • Jon needed a pain pump to control his symptoms
  • Don faced two illnesses at the same time
  • Bill also had prostate cancer