The Effects of Method of Anaesthesia on the Safety and Effectiveness of Radical Retropubic Prostatectomy

Measurement of patients systolic and diastolic blood pressure during the operation and post-operatively for 72 hours.

Measurement of patients Heart Rate during the operation and post-operatively for 72 hours.

Calculation of the Surgical APGAR score for each patient during surgery. The lower the score, on a scale of 1-10, the worst the prognosis of the patient. SAS is calculated using three variables: Estimated blood loss (on a 0-3 scale, 0 points >1000 ml, 1 point 601-1000ml, 2 points 101-600 ml, 3 points <100ml) Lowest mean arterial pressure (on a 0-3 scale, 0 points <40 mmHg, 1 point 40-54 mmHg, 2 points 55-69 mmHg, 3 points >70 mmHg) Lowest heart rate (on a 0-4 scale, 0 points >85 bpm, 1 points 76-85 bpm, 2 points 66-75 bmp, 3 points 56-65 bmp, 4 points <55 bmp) during surgery.

Measured from suction contents intra-operatively in ml

Haemoglobin measurement before the operation and at 12-, 24- and 48-hours post-operatively, in g/dL

Time required for: Induction of anaesthesia Completion of the operation Post-operative time until the patient is successfully transferred to the recovery room

Measured using a pain Visual Analogue Scale (VAS) at 6-, 24- and 48-hours after the operation. VAS is a self-reporting pain scale based on a 0 to 10-point system, with each point measuring 10mm on a linear line. Every patient was asked to indicate his pain levels from "No Pain" (equals 0) to "Worst Pain Imaginable" (equals 10).

Complications related to the procedure: Intraoperative bleeding Post-operative bleeding Bowel perforation Cardiovascular Respiratory Complications related to the anaesthesia technique performed: Post-operative headache Nausea and vomiting Any signs of potential nerve damage (manifested as inability to gain leg motility)

Measurement of Prostatic Specific Antigen (PSA) levels at 6 to establish a PSA nadir value

Measurement of Prostatic Specific Antigen (PSA) levels at 12 post-operation to detect any biochemical recurrence

Measured using the International Index of Erectile Function (IIEF-5) questionnaires pre-operatively and at 3-, 6- and 12-months post-surgery. The test is composed of 5 questions with 5 points for each question. Patients are evaluated accordingly: Score 22 or more = No Erectile Disfunction Score 17-21 = Mild Erectile Disfunction Score 12-16 = Mild to moderate Erectile Disfunction Score 8-11 = Moderate Erectile Disfunction Score 7 or less = Severe Erectile Disfunction Results will be: Analysed and compared to evaluate any potential difference of the two methods of anaesthesia, on post-operational erectile function Analysed comparing pre-operation with post-operation questioners overall, to evaluate erectile disfunction after radical prostatectomy regardless of method of anaesthesia.

Measured using the International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form at 12 months post-surgery. The Questionnaire is consisted of 4 questions: Frequency "How often do you leak urine?" on a scale of 0 (never) to 5 (all the time) Amount of leakage "How much urine do you leak?" on a scale to 0 (none) to 3 (a large amount) Overall impact on quality of life "How much does it interfere with your life?" on a scale of 0 (not at all) to 10 (a great deal) Timing of leakage "When does urine leak?"

Days until patient discharge from the hospital.

Satisfaction, using the Short Assessment of Patient Satisfaction (SAPS) Questionnaire, is measured in a scale of 0 to 28, with 0 to 10 equals to "Very Dissatisfied", 11-18 equals to "Dissatisfied", 19-26 equals to "Satisfied" and 27-28 equals to "Very Satisfied"