To the Editor: The rapid uptake of robotic radical prostatectomy has occurred despite minimal evidence of its superiority to the open approach. In the absence of a large randomized clinical trial comparing techniques, information regarding outcomes of these procedures is limited to observational studies, including those based on administrative data. Using population-based cancer registry data linked with Medicare claims, Dr Hu and colleagues1 reported greater rates of incontinence and erectile dysfunction with minimally invasive radical prostatectomy compared with open radical retropubic prostatectomy in men with prostate cancer.
Lowrance WT, Elkin EB, Eastham JA. Minimally Invasive vs Open Radical Prostatectomy. JAMA. 2010;303(7):619-620. doi:10.1001/jama.2010.126