Erectile function after laparoscopic versus robotic-assisted radical prostatectomy: A systematic review and meta-analysis
Bibliographic record
Abstract
Prostate cancer is a common malignancy in men over 50 years old, and radical prostatectomy, particularly via laparoscopic and robotic-assisted techniques, significantly impacts quality of life, especially in terms of erectile dysfunction. This systematic review and meta-analysis aimed to evaluate the preservation of erectile function following robotic-assisted and laparoscopic radical prostatectomy, with a separate analysis of randomized clinical trials and non-randomized studies. This review was carried out using randomized and non-randomized studies involving adult patients diagnosed with localized prostate cancer undergoing radical prostatectomy, according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and registered in PROSPERO. Applicable literature from PubMed, Cochrane, Embase, and the Latin American and Caribbean Health Sciences Literature database was analysed. The bias in randomized clinical trials was assessed using the Cochrane Risk of Bias 2.0 tool, and observational studies were evaluated via the Newcastle-Ottawa Scale. The statistical analysis was performed using Review Manager version 5.4. Our analysis included 13 studies involving 6281 patients. Comparative meta-analysis of non-randomized studies demonstrated that robotic techniques were significantly more effective in preserving erectile function at 3 months (risk difference [RD] 0.05, 95% confidence interval [CI] 0.00–0.11; p =0.040), 6 months (RD 0.10, 95% CI 0.03–0.17; p =0.006), and 12 months postoperatively (RD 0.06, 95% CI 0.02–0.10; p =0.002). Robotic-assisted surgery showed greater preservation of erectile function 3 months, 6 months, and 12 months after radical prostatectomy. However, additional studies with meticulous methodological criteria are necessary for future analysis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.027 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.021 | 0.042 |
| Bibliometrics | 0.005 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".