Neuropathy in the lower extremities after RALP

The occurrence of  lower extremity neuropathies (pain in the lower parts of the legs) is a relatively uncommon but regularly reported side effect of robot-assisted laparoscopic radical prostatectomy (RALP) and also of robot-assisted radical cystectomy (RALC), which is the surgical removal of the bladder.

Manny et al. have carried out a retrospective analysis of data from 179 consecutive patients who underwent either a RALP or RALC at one institution over a period of 17 months. Their cohort included all patients who experienced any type of lower extremity pain, weakness, or numbness at any time after their surgical treatment. In addition to a careful review of patient’s charts and other data, the researchers also conducted follow-up calls with many of the patients (although perhaps not all).

In addition, the authors defined postoperative neuropathy specifically as the development of new symptoms of neuropathy within 7 days of surgery.

The results of their study showed the following:

  • 6/179 patients complained of symptoms of lower extremity neuropathy within 9 months of follow-up.
  • Probable injuries were identified to the common peroneal, lateral femoral cutaneous, and obturator nerves.
  • 3/179 patients (1.7 percent) met the research team’s specific criteria for post-surgical neuropathy.
  • All patients remained able to walk despite their condition.
  • 1 patient — a man with metastatic bladder cancer — had activity-limiting neuropathic symptoms during the 9-month follow-up period.

The “New” Prostate Cancer InfoLink is pleased to see that this type of side effect of surgery is actually achieving some degree of recognition. In the full text of their paper, the authors suggest the routine use of common risk-minimizing strategies that may be able to help to avoid the occurrence of this type of side effect.

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