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Lower extremity neuropathy after robot assisted laparoscopic radical prostatectomy and radical cystectomy
Department of Urology, Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina, USA
Oct 2010 (Vol. 17, Issue 5, Pages( 5390 - 5393)
PMID: 20974033

Abstract

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  • INTRODUCTION:

    To describe the incidence and outcomes of lower extremity neuropathies in a series of robot assisted laparoscopic radical prostatectomy (RALRP) and robot assisted laparoscopic radical cystectomy (RALRC) patients with 9 months follow up. Additionally, we compare this cohort to other published series of lithotomy based surgery and describe strategies for minimizing risk.

    MATERIALS AND METHODS:

    We performed a retrospective analysis of 179 consecutive patients who underwent either RALRP or RALRC at a single institution during a 17 month period. We included all patients who experienced bothersome lower extremity pain, weakness, or numbness at any time during their postoperative course. We further defined postoperative neuropathy as de-novo symptoms presenting in the first week postoperatively. Chart review and telephone survey were used to further characterize these patients.

    RESULTS:

    Six out of 179 patients complained of lower extremity neuropathic symptoms by 9 months of follow up. Probable injuries to the common peroneal, lateral femoral cutaneous, and obturator nerves were found. Three patients met our criteria for postop neuropathy making the incidence 1.68%. All patients remained ambulatory throughout their course. At 9 months follow up, only one patient, a man with metastatic bladder cancer, had activity limiting neuropathic symptoms.

    CONCLUSIONS:

    With routine use of common risk minimizing strategies, RALRP or RALRC may result in lower extremity europathy at rates similar to other lithotomy based procedures described in the literature.

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canadian journal of urology