Physical and mental effects of different radical prostatectomy techniques on urologic surgeons

Physical and mental effects of different radical prostatectomy techniques on urologic surgeons | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Physical and mental effects of different radical prostatectomy techniques on urologic surgeons Mahmut Taha Ölçücü, Mustafa Suat Bolat, Kadir Yıldırım, Yasar Özgök, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3976248/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Oblective In this web-based international survey study, we aimed to show association between physical exhaustion, and patient, relatives, and employers-related mental stress on surgeons performing open radical prostatectomy (ORP), laparoscopic radical prostatectomy (LRP), and robot-assisted laparoscopic prostatectomy (RALP) . Methods A ten-question survey was sent to the urologists performing ORP, LRP, and RALP via e-mail and social media platforms. The techniques preferred by the participants and their possible associations with physical exhaustion, musculoskeletal complaints and stress caused by patients’ or patients’ relatives or employers’ expectations as well as regular exercise or sportive activities were investigated. Results A total of 160 urologists completed the survey. RALP group showed lower physical exhaustion rate and increased eye-strain (p 0.05). Conclusion Lower physical exhaustion was achieved in RALP technique compared to ORP and LRP. Although the number of participants limited, regular exercise weakly improved physical exhaustion and musculoskeletal complaints. We believe that encouraging the urologists dealing with LRP and RALP to force regular sportive activities would help to improve physical discomfort. Ergonomy Laparoscopy Open surgery Radical Prostatectomy Robotics 1. Introduction Radical prostatectomy is the primary surgical treatment for prostate cancer. Historically, open anatomic radical prostatectomy (ORP) and laparoscopic radical prostatectomy (LRP) were first introduced by Walsh et al.and Schuessler et al., respectively. 1, 2 Laparoscopic procedures have advantages over open procedures, including less postoperative pain and hospital stay, better recovery time, and more cosmetic satisfaction. However, laparoscopic surgery may cause physical and mental stress by causing excessive strain due to prolonged immobility of the surgeon's wrist, head, and neck secondary to the surgeon's position in the imaging systems and fixed The RALP surgery has been inroduced treatment algorithym by early 21st century . 3–5 The RALP technique provides ergonomic advantages such as easy manipulation with three-dimensional imaging and better operating posture for the surgeon in sitting position comared to LRP and ORP. 6, 7 Certain situations can create suboptimal conditions during a radical prostatectomy, such as patients, relatives, and employers, causing collective stress on surgeons. 8 Regular exercise and sportive activity have many physical and mental benefits. Various studies reported that regular exercise had a protective effect against chronic diseases such as cardiovascular diseases and cancers and reduced musculoskeletal system pain. 9–11 In this web-based international survey study, we aimed to show association between physical exhaustion, and patient, relatives, and employers-related mental stress on surgeons performing ORP, LRP, and RALP. 2. Materials and methods After obtaining of local ethics committee approval from Antalya Training and Research Hospital (Approval no: 2019-023) ten-question survey was created using the SurveyMonkey program ( www.SurveyMonkey.com ) and sent to the urologists performing radical prostatectomy via e-mail and social media platforms. An informed consent to participate was sent to all urologists with survey via e-email. In informed consent the aim of survey was clarified. Participants were asked the following questions regarding radical prostatectomy techniques (Supplemental File 1) ; Q1: Participants were asked which radical prostatectomy technique they preferred and how often they performed it. Q2: Stress arising from patients’ and their relatives. Q3: Stress arising from employers. Q4: Reasons causing stress on urologists during the surgery. Q5: Physically exhaustion status level secondary to the preferred technique. Q6: Musculoskeletal complaints during or after radical prostatectomy. Q7: Complaints affecting choice radical prostatectomy technique. Q8: Information regarding receiving professional support and medical treatment against to musculoskeletal complaints. Q8: Type of regular exercise and sportive activities preferred by surgeons. Q10. Demographic data of the participants Our first hypothesis was that RALP could cause less physical exhaustion and musculoskeletal complaints than the other techniques. The second hypothesis was that musculoskeletal complaints could be less seen in urologists who regularly exercise. 2.1 Statistical Analysis Statistical analysis was made using SPSS Statistics for Windows, Version 25.0 (IBM Corp., Armonk, NY). Data are expressed as n (%) or mean ± SD and median (min-max) as appropriate. The Shapiro-Wilk test controlled the normality assumptions. One-way ANOVA test was used for parametric variables, and the Kruskal Wallis test was used for non-parametric variables. Bonferroni-Dunn test was used as a posthoc test for significant cases. Age and BMI adjusted correlations between the various parameters were analyzed using the Spearman's rank test. A p-value of < 0.05 was considered statistically significant. 3. Results A total of 160 certified urologists working in private practice or in state or in University hospitals completed this survey-based study. Of the participants, 127 preferred ORP (79.37%), 58 LRP (36.25%) and 37 RALP (23.12%). Seventy-five (46.87%), 17 (46.87%) and 10 (6.25%) urologists were dealing with ORP, LRP and RALP only. Majority of the participants had surgical experience between 1-100 for all three techniques (98.42%, 93.10% and 91.89% for ORP, LRP and RALP, respectively p = 0.09). Two-thirds were suffering from stress secondary to attitude and behaviour of patients’ or their relatives’. The majority of surgeons were experiencing employer-origin stress. Morbid obesity (71.25%) and a history of previous abdominal surgery (51.87%) were the most common causes of stress among the participants. Three-forth participants declared no previous professional support and one-five never changed their surgical techniques (19.54%) (Table 1 ). Table 1 Rate of responses to questions 1–4 and questions 7 and 8. Q1. How many radical prostatectomy surgeries do you perform a year? (n = 160) Open Radical Prostatectomy Response n, (%) 1-100 125 (78.12)* 100–200 0 (0) 200–300 2 (1.25) >300 0 (0) Total 127 (79.37) Laparoscopic Radical Prostatectomy Response n (%) 1-100 54 (33.75)* 100–200 3 (1.87) 200–300 1 (0.62) >300 0 (0) Total 58 (36.25) Robot-assisted Radical Prostatectomy Response n (%) 1-100 34 (21.25)* 100–200 2 (1.25) 200–300 0 (0) >300 1 (0.62) Total 37 (23.12) Q2. Before the radical prostatectomy, Do your patients and/or their family (relatives) cause stress on you? Response (n = 160) n (%) Always 13 (8.12) Usually 49 (30.62) Sometimes 56 (35)* Rarely 32 ( 20 ) Never 10 (6.25) Q3. How often do expectations of your employer about radical prostatectomy cause stress on you? Response (n = 160) n (%) Always 3 (1.87) Usually 14 (8.75) Sometimes 32 ( 20 ) Rarely 47 (29.37) Never 64 (40)* Response (n = 160) n (%) Q4. During a radical prostatectomy, which of the following(s) cause(s) stress on you ? (multiple choice avaliable) None 1 (0.62) Patient with morbid obesity 114 (71.25)* Grade or stage of the disease 68 (42.5) Prior history of abdominal operation 83 (51.87) Frequent change of the surgical team 31 (19.37) Complications during or after the surgery 87 (54.37) Lack of standard postoperative care 17 (10.62) Postoperative follow-up 17 (10.62) Other 8 ( 5 ) Q7. Have you received any professional support for the complaints that you have experienced? (multiple choice avaliable) Response (n = 133) n (%) No 98 (73.68)* Lifestyle modifications 29 (21.80) Physical therapy modalities (Massage, TENS, dry needling, hot-cold compress, stretching) 22 (16.54) Medical treatment(s) 13 (9.77) Surgery 4 ( 3 ) Other 3 (2.25) Q8. Do/Does your complaint(s) affect your choice of radical prostatectomy technique ? Response (n = 133) n (%) Always 1 (0.75) Usually 14 (10.52) Sometimes 9 (6.76) Rarely 58 (43.6)* Never 26 (19.54) I can perform only one type of technique 25 (18.79) Q1. How many radical prostatectomy surgeries do you perform a year ? (n = 160) Open Radical Prostatectomy Response n, (%) 1-100 119 (74.37)* 100–200 0 (0) 200–300 2 (1.25) >300 0 (0) Total 121 (75.62) Laparoscopic Radical Prostatectomy Response n (%) 1-100 54 (33.75)* 100–200 4 (2.5) 200–300 1 (0.62) >300 0 (0) Total 59 (36.87) Robot-assisted Radical Prostatectomy Response n (%) 1-100 42 (26.25)* 100–200 5 (3.12) 200–300 0 (0) >300 1 (0.62) Total 48 (30) Q2. Before the radical prostatectomy, Do your patients and/or their family (relatives) cause stress on you? Response (n = 160) n (%) Always 13 (8.12) Usually 49 (30.62) Sometimes 56 (35)* Rarely 32 ( 20 ) Never 10 (6.25) Q3. How often do expectations of your employer about radical prostatectomy cause stress on you? Response (n = 160) n (%) Always 3 (1.87) Usually 14 (8.75) Sometimes 32 ( 20 ) Rarely 47 (29.37) Never 64 (40)* Response (n = 160) n (%) Q4. During a radical prostatectomy, which of the following(s) cause(s) stress on you ? (multiple choice avaliable) None 1 (0.62) Patient with morbid obesity 114 (71.25)* Grade or stage of the disease 68 (42.5) Prior history of abdominal operation 83 (51.87) Frequent change of the surgical team 31 (19.37) Complications during or after the surgery 87 (54.37) Lack of standard postoperative care 17 (10.62) Postoperative follow-up 17 (10.62) Other 8 ( 5 ) Q7. Have you received any professional support for the complaints that you have experienced? (multiple choice avaliable) Response (n = 133) n (%) No 98 (73.68)* Lifestyle modifications 29 (21.80) Physical therapy modalities (Massage, TENS, dry needling, hot-cold compress, stretching) 22 (16.54) Medical treatment(s) 13 (9.77) Surgery 4 ( 3 ) Other 3 (2.25) Q8. Do/Does your complaint(s) affect your choice of radical prostatectomy technique ? Response (n = 133) n (%) Always 1 (0.75) Usually 14 (10.52) Sometimes 9 (6.76) Rarely 58 (43.6)* Never 26 (19.54) I can perform only one type of technique 25 (18.79) BMI, body-mass index; SD, standard deviation; TENS, transcutaneous electrical nerve stimulation *Multiple responses available Considering the preferred surgical technique, the mean age and BMI of the participants were similar (p > 0.05). RALP group showed better physical exhaustion than LRP and ORP groups (p 0.05) (Table 2 ). Most of the surgeons preferred walking among the sportive activities (Table 3 and Supplemental Table 1). Table 2 Demographic data and analysis of responses to questions 5 and 6 between groups. Open RP (n = 127) Mean ± SD Median (min-max) Laparoscopic RP (n = 58) Mean ± SD Median (min-max) Robot-assisted RP (n = 37) Mean ± SD Median (min-max) P value Age (year) 45.83 ± 0.87 45 (29–71) 44.24 ± 1.17 43 (29–65) 45.70 ± 1.76 43 (29–76) 0.555 BMI 26.97 ± 0.97 26.89 (20.04–35.56) 26.55 ± 0.41 26.22 (19.83–36.24) 27.19 ± 0.59 27.47 (20.04–34.63) 0.683 Q5. How much does/do the preferred technique(s) exhaust you physically? Open RP (n = 127) Mean ± SD Median (min-max) Laparoscopic RP (n = 58) Mean ± SD Median (min-max) Robot-assisted RP (n = 37) Mean ± SD Median (min-max) P value Answers 4.85 ± 2.32 a 5 (0–10) 5.10 ± 2.62 a 5 (0–9) 2.7 ± 1.89 b 2 (0–8) < 0.001* Q6. Which of these complaints do you experience during or after performing radical prostatectomy with the preferred technique(s) ? Open RP (n = 127) Mean ± SD Median (min-max) Laparoscopic RP (n = 58) Mean ± SD Median (min-max) Robot-assisted RP (n = 37) Mean ± SD Median (min-max) P value Forehead pain 0.88 ± 1.66 0 (0–8) 1.17 ± 2.18 0 (0–9) 1.54 ± 2.30 1 (0–9) 0.108 Eye strain 0.82 ± 1.63 a 0 (0–8) 1.53 ± 2.22 a, b 0 (0–8) 2.16 ± 2.58 b 0 (0–9) 0.001 * Neck pain 2.17 ± 2.72 0 (0–10) 2.21 ± 2.61 0 (0–9) 2.19 ± 2.50 1 (0–8) 0.861 Back pain 2.53 ± 2.80 2 (0–10) 2.83 ± 2.78 3 (0–10) 1.84 ± 2.67 0 (0–9) 0.170 Shoulder stiffness 1.20 ± 2.33 0 (0–10) 1.79 ± 2.62 0 (0–10) 1.35 ± 2.12 0 (0–9) 0.252 Chest pain 0.39 ± 1.08 0 (0–7) 0.50 ± 1.60 0 (0–8) 0.30 ± 0.52 0 (0–2) 0.551 Arm pain 1.50 ± 2.46 0 (0–10) 1.74 ± 2.80 0 (0–10) 0.81 ± 1.61 0 (0–7) 0.436 Forearm pain 1.06 ± 2.26 0 (0–10) 1.07 ± 2.14 0 (0–8) 0.81 ± 1.72 0 (0–8) 0.880 Elbow stiffness 0.51 ± 1.51 0 (0–10) 0.90 ± 2.06 0 (0–8) 0.89 ± 2.17 0 (0–9) 0.432 Hand pain 1.22 ± 2.16 0 (0–10) 0.90 ± 1.83 0 (0–7) 1.86 ± 2.80 0 (0–8) 0.164 Wrist stiffness 0.98 ± 2.04 0 (0–10) 1.09 ± 2.1 0 (0–9) 1.38 ± 2.53 0 (0–8) 0.501 Finger numbness 1.11 ± 2.11 0 (0–8) 1.78 ± 2.62 0 (0–10) 1.86 ± 2.94 0 (0–9) 0.170 Leg pain 1.83 ± 2.78 0 (0–10) 2.43 ± 2.97 1 (0–9) 1.32 ± 2.29 0 (0–9) 0.270 Total Complaints 14.97 ± 27.42 10 (0–97) 19.03 ± 18.84 14.50 (0–83) 16.45 ± 17.87 13 (0–60) 0.223 BMI, body-mass index; RP, radical prostatectomy, SD, standard deviation, * Significant p values, a, b, c Different lowercases denote statistically significant differences. - Visual analog scale (0–10) was used to score for the complaints. Table 3 Frequency of weekly excercise in response to question 9. 0/week n, (%) 1/week n, (%) 2/week n, (%) 3/week n, (%) 4/week n, (%) 5/week n, (%) 6/week Nn, (%) 7/week n, (%) Walking 45 (28.12) 10 (6.25) 21 (13.12) 29 (18.12) 13 (8.12) 16 ( 10 ) 6 (3.75) 20 (12.5) Running 115 (71.87) 14 (8.75) 8 ( 5 ) 16 ( 10 ) 4 (2.5) 1 (0.62) 0 (0) 2 (1.25) Bicycling 132 (82.50) 11 (6.87) 6 (3.75) 2 (1.25) 4 (2.5) 2 (1.25) 1 (0.62) 2 (1.25) Swimming 136 (85) 7 (4.37) 5 (3.12) 3 (1.87) 2 (1.25) 3 (1.87) 3 (1.87) 1 (0.62) Football 148 (92.5) 8 ( 5 ) 3 (1.87) 0 (0) 0 (0) 0 (0) 0 (0) 1 (0.62) Basketball 151 (94.37) 4 (2.5) 4 (2.5) 0 (0) 1 (0.62) 0 (0) 0 (0) 0 (0) Volleyball 156 (97.5) 2 (1.25) 2 (1.25) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) Tennis 154 (96.25) 4 (2.5) 1 (0.62) 0 (0) 0 (0) 1 (0.62) 0 (0) 0 (0) Golf 157 (98.12) 1 (0.62) 1 (0.62) 1 (0.62) 0 (0) 0 (0) 0 (0) 0 (0) Weight Lifting 136 (85) 3 (1.87) 8 ( 5 ) 8 ( 5 ) 2 (1.25) 2 (1.25) 0 (0) 1 (0.62) Boxing 154 (96.25) 1 (0.62) 3 (1.87) 2 (1.25) 0 (0) 0 (0) 0 (0) 0 (0) Meditation 151 (94.37) 2 (1.25) 3 (1.87) 1 (0.62) 2 (1.25) 0 (0) 0 (0) 0 (0) Yoga 153 (95.62) 2 (1.25) 2 (1.25) 2 (1.25) 1 (0.62) 0 (0) 0 (0) 0 (0) Pilates 155 (96.87) 2 (1.25) 0 (0) 1 (0.62) 0 (0) 0 (0) 0 (0) 2 (1.25) 4. Discussion Many conditions may cause stress on surgeons, including patient-related, work-related, social and self-related factors. 12 Major surgeries using minimally invasive techniques may in itself be one of the main causes of increased stress on surgeons. It is well-known that increased stress factor may negatively affect the surgical outcomes and cntrolling stress factors can increase surgical success. 10 A report from Turkey showed that gradual increase of stressful situations could cause psychological deterioration and a consequent burnout syndrome that is quite common in urologists in Turkey. 8 Minimally invasive methods are more beneficial for patients but do not always provide an ergonomic convenience for surgeons. 13 Despite its minimally invasive nature, laparoscopy can cause surgeon discomfort due to posture, vision, and instrumentation limitations. Morbid obesity one of the reasons that may cause greater stress to surgeons by increasing the risk of intra-operative and postoperative complications. Consistent with previous reports, our results showed that 71.25% of surgeons are stressed due to obesity-related complications when performing radical prostatectomy.Contrary to these reports, Eden et al. stated that obesity only increased operative time for laparoscopic prostatectomy but did not impact other intraoperative and postoperative surgical parameters, possibly due to high number of surgical experience. 14 Our results regarding the relationship between physical complaints and exercise showed that regular physical activity improved some physical complaints such as elbow stiffness, hand and leg pain, and finger numbness, although low number of participants. Laparoscopy is related to suboptimal static posture. A study investigating the effects of the ETHOS surgical chair, three-dimensional technology, and Radius Surgical System manipulators on surgical time and surgeon comfort reported a similar surgical time and comfort rate to the da Vinci technique compared to the classical laparoscopic method. 15 Despite a report advocating that the RALP was a user-friendly interface due to 3D vision, Lee et al. reported that 56.1% of surgeons experienced physical discomfort. 16 Similar to that report, Tokas commented that LRP caused distress in the upper back, shoulders, arms, and wrist, but RALP was associated with higher discomfort in the forehead, neck, and trunk. 17 This finding supports our hypothesis regarding the RALP could cause less physical exhaustion and musculoskeletal complaints than the other techniques. 18 Among open, laparoscopic and robot-assisted radical prostatectomy techniques, the RALP technique was related to lower physical exhaustion, possibly due to it is performed in a sitting position, provides a 3-dimensional view and is associated with much more comfortable hand and wrist movements. 7, 19 A report was published comparing robotic surgery and conventional laparoscopy on the muscle groups that surgeons use most frequently during surgery, and the authors stated that robotic-assisted laparoscopic surgery was more advantageous than conventional laparoscopy in experienced hands. 19 The results of a meta-analysis investigating the effects of exercise on the locomotor system showed that regular activity or exercise was beneficial in individuals with chronic musculoskeletal pain . 20 Studies conducted to complete the learning curve showed that 30–50 consecutive cases would be sufficient for robotic or laparoscopic surgery. 21, 22 In our study, the majority of the participants had experience of up to 100 cases for all three different prostatectomy techniques. In accordance with the literature, our finding on physical strain showed that surgeons performing RALP experienced an increase in eye strain, while other complaints were similar. 23 Our findings support that the RALP technique is superior to the other techniques when physical strain is taken into consideration. Significant ergonomic problems, especially finger numbness and eye strain may more likely occur during laparoscopic surgery and younger surgeons tend to be more affected. Hemal et al. concluded in their study that surgeons performing a laparoscopy have significant ergonomic problems, especially finger numbness and eye strain, and younger laparoscopic surgeons were more affected 4 . Matern et al. reported that muscle strength applied during the use of laparoscopic instruments might increase up to six-fold greater compared to open surgery. 24 Despite this challenging aspect of laparoscopic surgery, our results showed that 63.14% of surgeons did not change their choice of radical prostatectomy technique. One of the remarkable findings of this study is that while only 18.79% of surgeons used only one prostatectomy technique, majority of the participants were willing to new surgical techniques. One of the remarkable findings of this study is that while only 18.79% of surgeons used only one prostatectomy technique, majority of the participants were willing to new surgical techniques. This finding might be a reason for likelihood of increased exhaustion until learning curve has been completed. One of the remarkable findings of this study is that while only 18.79% of surgeons used only one prostatectomy technique, majority of the participants were willing to new surgical techniques. This finding might be a reason for likelihood of increased exhaustion until learning curve has been completed. Indeed, considering that all groups had an experience up to 100 cases per year, physical exhaustion rate was significantly lower in robotic arm than the others possibly due to better ergonomy and three-D vision advantages. In this study, majority of urologists preferred walking. There was a slight correlation between regular physical activity and reduced musculoskeletal complaints in surgeons who performed radical prostatectomy. Fitness exercise can be a solution for avoiding and maybe buffering the musculoskeletal strain during the operation. 25 Some authors stated that regular sportive activity might be protective from exhausting. 26 A relationship between insufficient exercise and chronic diseases has been described. 27 A meta-analytical study shoed that regular and adequate exercise positively affected various musculoskeletal complaints without the additional treatment cost. 28 In a web-based survey study conducted among 701 urologists worldwide, walking and running were found to be the most common types of exercise, similar to our results, and the protective effect of exercise on development of low back pain was demonstrated. 29 Urologists performing regular exercise or sportive activities face lower physical exhaustion and musculoskeletal complaints that support our hypothesis. We believe that encouraging urologists dealing with LRP and RALP to engage in regular sportive activities would help to improve physical discomfort. Several factors limit the strength of this study, including lack of assessment of comorbidities, level of experience in the profession, monthly income levels, and relatively low number of participants. 5. Conclusion This study concluded that the RALP technique caused less physical exhaustion than the ORP and LRP techniques. Further comprehensive studies with larger participants are needed to validate these results. Although regular exercise weakly improved physical exhaustion and musculoskeletal complaints, we believe that encouraging urologists dealing with LRP and RALP to engage in regular sportive activities would help to improve physical discomfort. Abbreviations BMI body mass index LRP laparoscopic radical prostatectomy ORP open radical prostatectomy RALP robot-assisted laparoscopic prostatectomy Q question. Declarations Ethics approval and consent to participate Institutional Review Board Training and Research Hospital (Approval no: 2019-023). Informed consent to participate was sent to all urologists via e-email. In informed consent the aim of survey was clarified. Informed consent was obtained from all participants Consent for publication Not Applicable Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request Competing Interests Authors declare that there is no conflict of interest. Funding None Authors' contributions Study design: M.T.O and A.S.G. ; Coordination: Y.O, M.T.O. M.S.B.; Data gathering: M.T.O., K.Y., M.S.B.; Data analysis:M.T.O. , M.S.B. and K.Y..; Interpretation of results: M.T.O , A.S.G and M.S.B. ; Drafting the manuscript: M.T.O :M.S.B ,A.S.G and T.T.; Final revision of the manuscripts: A.S.G , Y.O and T.T. All authors have read and approved the manuscript. Acknowledgment As authors, we would like to thank the Turkish Association of Urology, Turkish Endourology Society, Turkurolap Education and Research Group for their support in reaching out to member of urologists. References Walsh PC, Donker PJ. Impotence following radical prostatectomy: insight into etiology and prevention. J Urol. 1982;128:492–7. Ww S, Kavoussi LR, Clayman RV, Vancaillie TH. Laparoscopic radical prostatectomy: initial case report. J Urol. 1992;147:246A. Gofrit ON, Mikahail AA, Zorn KC, Zagaja GP, Steinberg GD, Shalhav AL. Surgeons’ perceptions and injuries during and after urologic laparoscopic surgery. Urology. 2008;71:404–7. Hemal A, Srinivas M, Charles A. Ergonomic problems associated with laparoscopy. J Endourol. 2001;15:499–503. Pasticier G, Rietbergen JB, Guillonneau B, Fromont G, Menon M, Vallancien G. Robotically assisted laparoscopic radical prostatectomy: feasibility study in men. Eur Urol. 2001;40:70–4. Bagrodia A, Raman JD. Ergonomic considerations of radical prostatectomy: physician perspective of open, laparoscopic, and robot-assisted techniques. J Endourol. 2009;23:627–33. Andolfi C, Kumar R, Boysen WR, Gundeti MS. Current Status of Robotic Surgery in Pediatric Urology. J Laparoendosc Adv Surg Tech A. 2019;29:159–66. Bolat MS, Yuruk E, Cinar O, Akdeniz E, Altunrende F, Ozkuvanci U, et al. The prevalence of Burnout Syndrome among Turkish Urologists: Results of a Nationwide Survey. Turk J Urol. 2019;45:449–55. Wewege MA, Thom JM, Rye KA, Parmenter BJ. Aerobic, resistance or combined training: A systematic review and meta-analysis of exercise to reduce cardiovascular risk in adults with metabolic syndrome. Atherosclerosis. 2018;274:162–71. Cheville AL, Smith SR, Basford JR. Rehabilitation Medicine Approaches to Pain Management. Hematol Oncol Clin N Am. 2018;32:469–82. Rosenbaum S, Sherrington C. Is exercise effective in promoting mental well-being in older age? A systematic review. Br J Sports Med. 2011;45:1079–80. Arora S, Sevdalis N, Nestel D, Woloshynowych M, Darzi A, Kneebone R. The impact of stress on surgical performance: a systematic review of the literature. Surgery. 2010;147:318–30. 330 e311-316. Renda A, Vallancien G. Principles and advantages of robotics in urologic surgery. Curr Urol Rep. 2003;4:114–8. Eden CG, Chang CM, Gianduzzo T, Moon DA. The impact of obesity on laparoscopic radical prostatectomy. BJU Int. 2006;98:1279–82. Tokas T, Gozen AS, Avgeris M, Tschada A, Fiedler M, Klein J, et al. Combining of ETHOS Operating Ergonomic Platform, Three-dimensional Laparoscopic Camera, and Radius Surgical System Manipulators Improves Ergonomy in Urologic Laparoscopy: Comparison with Conventional Laparoscopy and da Vinci in a Pelvi Trainer. Eur Urol focus. 2017;3:413–20. Lee GI, Lee MR, Green I, Allaf M, Marohn MR. Surgeons' physical discomfort and symptoms during robotic surgery: a comprehensive ergonomic survey study. Surg Endosc. 2017;31:1697–706. Tokas T. Comment on: Surgeons' posture and muscle strain during laparoscopic and robotic surgery. Br J Surg. 2020;107:e282. Rassweiler J, Hruza M, Klein J, Goezen AS, Teber D. The role of laparoscopic radical prostatectomy in the era of robotic surgery. Eur Urol Supplements. 2010;9:379–87. Dalager T, Søgaard K, Bech KT, Mogensen O, Jensen PT. Musculoskeletal pain among surgeons performing minimally invasive surgery: a systematic review. Surg Endosc. 2017;31:516–26. O'Connor SR, Tully MA, Ryan B, Bleakley CM, Baxter GD, Bradley JM, et al. Walking exercise for chronic musculoskeletal pain: systematic review and meta-analysis. Arch Phys Med Rehabil. 2015;96:724–34. e723. Menon M, Shrivastava A, Tewari A, Sarle R, Hemal A, et al. Laparoscopic and robot assisted radical prostatectomy: establishment of a structured program and preliminary analysis of outcomes. J Urol. 2002;168:945–9. Fabrizio MD, Tuerk I, Schellhammer PF. Laparoscopic radical prostatectomy: decreasing the learning curve using a mentor initiated approach. J Urol. 2003;169:2063–5. Plerhoples TA, Hernandez-Boussard T, Wren SM. The aching surgeon: a survey of physical discomfort and symptoms following open, laparoscopic, and robotic surgery. J Robot Surg. 2012;6:65–72. Matern U, Waller P. Instruments for minimally invasive surgery: principles of ergonomic handles. Surg Endosc. 1999;13:174–82. Schlussel AT, Maykel JA. Ergonomics and Musculoskeletal Health of the Surgeon. Clin Colon Rectal Surg. 2019;32:424–34. De Hert S. Burnout in Healthcare Workers: Prevalence, Impact and Preventative Strategies. Local Reg Anesth. 2020;13:171–83. Booth FW, Roberts CK, Laye MJ. Lack of exercise is a major cause of chronic diseases. Compr Physiol. 2012;2:1143–211. Miyamoto GC, Lin CC, Cabral CMN, van Dongen JM, van Tulder MW. Cost-effectiveness of exercise therapy in the treatment of non-specific neck pain and low back pain: a systematic review with meta-analysis. Br J Sports Med. 2019;53:172–81. Lloyd GL, Chung ASJ, Steinberg S, Sawyer M, Williams DH, Overbey D. Is Your Career Hurting You? The Ergonomic Consequences of Surgery in 701 Urologists Worldwide. J Endourol. 2019;33:1037–42. Additional Declarations No competing interests reported. Supplementary Files SUPPLEMENTALFILE1SURVEYQUESTIONS.pdf SupplementalTable1..docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3976248","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":278721866,"identity":"da3f2bd2-f510-46d8-89c0-1ee26d46fe27","order_by":0,"name":"Mahmut Taha Ölçücü","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1ElEQVRIiWNgGAWjYJACZiCW4ZcAsyVkiNIA0sIjOYOBsQGohYd4LQY3wFoYCGvRbT9/8HMBgw2P8e3m449u1FjwMLAfProBnxazM8nM0jMY0njM7hxLbM45BnQYT1raDbxaDiQzSPMwHOYxu5Fj2JzDBtQiAWTj1XL+MfNvkBbjGSAt/4jRciOZDWyLgQRQS24bUVoem1nzAP0icSMtcXZunwQPG0G/nE98fJuHwUaOf0bygc853+rk+NkPH8OrBQwY/yFx2AgqHwWjYBSMglFAEAAAe+Q/cMgv+LQAAAAASUVORK5CYII=","orcid":"","institution":"University of Health Sciences, Antalya Training and Research Hospital,Antalya","correspondingAuthor":true,"prefix":"","firstName":"Mahmut","middleName":"Taha","lastName":"Ölçücü","suffix":""},{"id":278721867,"identity":"e98297c5-7d68-4d86-9887-ac9afc94c6fe","order_by":1,"name":"Mustafa Suat Bolat","email":"","orcid":"","institution":"Atilim University Medical Faculty, Ankara","correspondingAuthor":false,"prefix":"","firstName":"Mustafa","middleName":"Suat","lastName":"Bolat","suffix":""},{"id":278721868,"identity":"50389693-991b-4b51-9ef9-cd66cef34eba","order_by":2,"name":"Kadir Yıldırım","email":"","orcid":"","institution":"Malatya Turgut Özal Medical Faculty Hospital, Malatya","correspondingAuthor":false,"prefix":"","firstName":"Kadir","middleName":"","lastName":"Yıldırım","suffix":""},{"id":278721869,"identity":"6e33ee3b-670b-4ac4-9e5f-ce4dfc688b66","order_by":3,"name":"Yasar Özgök","email":"","orcid":"","institution":"Ankara Yuksek Ihtisas University, Medical Faulty, Ankara","correspondingAuthor":false,"prefix":"","firstName":"Yasar","middleName":"","lastName":"Özgök","suffix":""},{"id":278721870,"identity":"74217422-548c-46b2-b0fd-46ed47e746dd","order_by":4,"name":"Theodoros Tokas","email":"","orcid":"","institution":"General Hospital Hall i.T., Department of Urology and Andrology, Hall in Tirol","correspondingAuthor":false,"prefix":"","firstName":"Theodoros","middleName":"","lastName":"Tokas","suffix":""},{"id":278721871,"identity":"d501aab8-2b57-45d1-883a-8b39ae033d43","order_by":5,"name":"Ali Serdar Gözen","email":"","orcid":"","institution":"University of Tubingen, Medical Clinic, Stuttgart","correspondingAuthor":false,"prefix":"","firstName":"Ali","middleName":"Serdar","lastName":"Gözen","suffix":""}],"badges":[],"createdAt":"2024-02-21 16:21:31","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3976248/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3976248/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":54357167,"identity":"9541df88-89dc-4914-aed3-d2cb95a47589","added_by":"auto","created_at":"2024-04-09 10:06:39","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1024550,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3976248/v1/55ce1360-7947-4733-a33f-7d2e736c5070.pdf"},{"id":52575482,"identity":"68ebaa39-c655-453f-b14b-01d3414c4aa4","added_by":"auto","created_at":"2024-03-13 06:44:01","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":79892,"visible":true,"origin":"","legend":"","description":"","filename":"SUPPLEMENTALFILE1SURVEYQUESTIONS.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3976248/v1/2e5960d0df2472b41edb2277.pdf"},{"id":52575481,"identity":"89421a7f-d3e4-45df-ae28-094486545efd","added_by":"auto","created_at":"2024-03-13 06:44:00","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":22164,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementalTable1..docx","url":"https://assets-eu.researchsquare.com/files/rs-3976248/v1/01f98cd928063134c85efe3c.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Physical and mental effects of different radical prostatectomy techniques on urologic surgeons","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eRadical prostatectomy is the primary surgical treatment for prostate cancer. Historically, open anatomic radical prostatectomy (ORP) and laparoscopic radical prostatectomy (LRP) were first introduced by Walsh et al.and Schuessler et al., respectively. \u003csup\u003e1, 2\u003c/sup\u003eLaparoscopic procedures have advantages over open procedures, including less postoperative pain and hospital stay, better recovery time, and more cosmetic satisfaction. However, laparoscopic surgery may cause physical and mental stress by causing excessive strain due to prolonged immobility of the surgeon's wrist, head, and neck secondary to the surgeon's position in the imaging systems and fixed The RALP surgery has been inroduced treatment algorithym by early 21st century .\u003csup\u003e3\u0026ndash;5\u003c/sup\u003e The RALP technique provides ergonomic advantages such as easy manipulation with three-dimensional imaging and better operating posture for the surgeon in sitting position comared to LRP and ORP. \u003csup\u003e6, 7\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eCertain situations can create suboptimal conditions during a radical prostatectomy, such as patients, relatives, and employers, causing collective stress on surgeons. \u003csup\u003e8\u003c/sup\u003eRegular exercise and sportive activity have many physical and mental benefits. Various studies reported that regular exercise had a protective effect against chronic diseases such as cardiovascular diseases and cancers and reduced musculoskeletal system pain. \u003csup\u003e9\u0026ndash;11\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eIn this web-based international survey study, we aimed to show association between physical exhaustion, and patient, relatives, and employers-related mental stress on surgeons performing ORP, LRP, and RALP.\u003c/p\u003e"},{"header":"2. Materials and methods","content":"\u003cp\u003eAfter obtaining of local ethics committee approval from Antalya Training and Research Hospital (Approval no: 2019-023) ten-question survey was created using the SurveyMonkey program (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ewww.SurveyMonkey.com\u003c/span\u003e\u003cspan address=\"http://www.SurveyMonkey.com\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e) and sent to the urologists performing radical prostatectomy via e-mail and social media platforms. An informed consent to participate was sent to all urologists with survey via e-email. In informed consent the aim of survey was clarified.\u003c/p\u003e \u003cp\u003eParticipants were asked the following questions regarding radical prostatectomy techniques (Supplemental File 1) ;\u003c/p\u003e \u003cp\u003eQ1: Participants were asked which radical prostatectomy technique they preferred and how often they performed it.\u003c/p\u003e \u003cp\u003eQ2: Stress arising from patients\u0026rsquo; and their relatives.\u003c/p\u003e \u003cp\u003eQ3: Stress arising from employers.\u003c/p\u003e \u003cp\u003eQ4: Reasons causing stress on urologists during the surgery.\u003c/p\u003e \u003cp\u003eQ5: Physically exhaustion status level secondary to the preferred technique.\u003c/p\u003e \u003cp\u003eQ6: Musculoskeletal complaints during or after radical prostatectomy.\u003c/p\u003e \u003cp\u003eQ7: Complaints affecting choice radical prostatectomy technique.\u003c/p\u003e \u003cp\u003eQ8: Information regarding receiving professional support and medical treatment against to musculoskeletal complaints.\u003c/p\u003e \u003cp\u003eQ8: Type of regular exercise and sportive activities preferred by surgeons.\u003c/p\u003e \u003cp\u003eQ10. Demographic data of the participants\u003c/p\u003e \u003cp\u003eOur first hypothesis was that RALP could cause less physical exhaustion and musculoskeletal complaints than the other techniques. The second hypothesis was that musculoskeletal complaints could be less seen in urologists who regularly exercise.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Statistical Analysis\u003c/h2\u003e \u003cp\u003eStatistical analysis was made using SPSS Statistics for Windows, Version 25.0 (IBM Corp., Armonk, NY). Data are expressed as n (%) or mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD and median (min-max) as appropriate. The Shapiro-Wilk test controlled the normality assumptions. One-way ANOVA test was used for parametric variables, and the Kruskal Wallis test was used for non-parametric variables. Bonferroni-Dunn test was used as a posthoc test for significant cases. Age and BMI adjusted correlations between the various parameters were analyzed using the Spearman's rank test. A p-value of \u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cp\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003eA total of 160 certified urologists working in private practice or in state or in University hospitals completed this survey-based study. Of the participants, 127 preferred ORP (79.37%), 58 LRP (36.25%) and 37 RALP (23.12%). Seventy-five (46.87%), 17 (46.87%) and 10 (6.25%) urologists were dealing with ORP, LRP and RALP only. Majority of the participants had surgical experience between 1-100 for all three techniques (98.42%, 93.10% and 91.89% for ORP, LRP and RALP, respectively p\u0026thinsp;=\u0026thinsp;0.09). Two-thirds were suffering from stress secondary to attitude and behaviour of patients\u0026rsquo; or their relatives\u0026rsquo;. The majority of surgeons were experiencing employer-origin stress. Morbid obesity (71.25%) and a history of previous abdominal surgery (51.87%) were the most common causes of stress among the participants. Three-forth participants declared no previous professional support and one-five never changed their surgical techniques (19.54%) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRate of responses to questions 1\u0026ndash;4 and questions 7 and 8.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eQ1. How many radical prostatectomy surgeries do you perform a year? (n\u0026thinsp;=\u0026thinsp;160)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e\u003cb\u003eOpen Radical Prostatectomy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eResponse\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en, (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1-100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e125 (78.12)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100\u0026ndash;200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e200\u0026ndash;300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (1.25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e127 (79.37)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e\u003cb\u003eLaparoscopic Radical Prostatectomy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eResponse\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1-100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54 (33.75)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100\u0026ndash;200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (1.87)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e200\u0026ndash;300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0.62)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58 (36.25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e\u003cb\u003eRobot-assisted Radical Prostatectomy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eResponse\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1-100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34 (21.25)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100\u0026ndash;200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (1.25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e200\u0026ndash;300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0.62)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37 (23.12)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e\u003cb\u003eQ2. Before the radical prostatectomy, Do your patients and/or their family (relatives) cause stress on you?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eResponse (n\u0026thinsp;=\u0026thinsp;160)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (8.12)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUsually\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49 (30.62)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56 (35)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32 (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (6.25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e\u003cb\u003eQ3. How often do expectations of your employer about radical prostatectomy cause stress on you?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eResponse (n\u0026thinsp;=\u0026thinsp;160)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (1.87)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUsually\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (8.75)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32 (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47 (29.37)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64 (40)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eResponse (n\u0026thinsp;=\u0026thinsp;160)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"8\" rowspan=\"9\"\u003e \u003cp\u003e\u003cb\u003eQ4. During a radical prostatectomy, which of the following(s) cause(s) stress on you\u003c/b\u003e? \u003cb\u003e(multiple choice avaliable)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0.62)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient with morbid obesity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e114 (71.25)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGrade or stage of the disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68 (42.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrior history of abdominal operation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e83 (51.87)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequent change of the surgical team\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31 (19.37)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eComplications during or after the surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e87 (54.37)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLack of standard postoperative care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17 (10.62)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePostoperative follow-up\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17 (10.62)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e\u003cb\u003eQ7. Have you received any professional support for the complaints that you have experienced? (multiple choice avaliable)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eResponse (n\u0026thinsp;=\u0026thinsp;133)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e98 (73.68)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLifestyle modifications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29 (21.80)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePhysical therapy modalities (Massage, TENS, dry needling, hot-cold compress, stretching)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (16.54)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedical treatment(s)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (9.77)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (2.25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e\u003cb\u003eQ8. Do/Does your complaint(s) affect your choice of radical prostatectomy technique\u003c/b\u003e?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eResponse (n\u0026thinsp;=\u0026thinsp;133)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0.75)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUsually\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (10.52)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (6.76)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58 (43.6)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26 (19.54)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI can perform only one type of technique\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (18.79)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQ1. How many radical prostatectomy surgeries do you perform a year\u003c/b\u003e? \u003cb\u003e(n\u0026thinsp;=\u0026thinsp;160)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e\u003cb\u003eOpen Radical Prostatectomy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eResponse\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en, (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1-100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e119 (74.37)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100\u0026ndash;200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e200\u0026ndash;300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (1.25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e121 (75.62)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e\u003cb\u003eLaparoscopic Radical Prostatectomy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eResponse\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1-100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54 (33.75)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100\u0026ndash;200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (2.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e200\u0026ndash;300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0.62)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59 (36.87)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e\u003cb\u003eRobot-assisted Radical Prostatectomy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eResponse\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1-100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42 (26.25)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100\u0026ndash;200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (3.12)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e200\u0026ndash;300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0.62)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48 (30)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e\u003cb\u003eQ2. Before the radical prostatectomy, Do your patients and/or their family (relatives) cause stress on you?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eResponse (n\u0026thinsp;=\u0026thinsp;160)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (8.12)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUsually\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49 (30.62)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56 (35)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32 (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (6.25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e\u003cb\u003eQ3. How often do expectations of your employer about radical prostatectomy cause stress on you?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eResponse (n\u0026thinsp;=\u0026thinsp;160)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (1.87)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUsually\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (8.75)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32 (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47 (29.37)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64 (40)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eResponse (n\u0026thinsp;=\u0026thinsp;160)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"8\" rowspan=\"9\"\u003e \u003cp\u003e\u003cb\u003eQ4. During a radical prostatectomy, which of the following(s) cause(s) stress on you\u003c/b\u003e? \u003cb\u003e(multiple choice avaliable)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0.62)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient with morbid obesity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e114 (71.25)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGrade or stage of the disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68 (42.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrior history of abdominal operation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e83 (51.87)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequent change of the surgical team\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31 (19.37)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eComplications during or after the surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e87 (54.37)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLack of standard postoperative care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17 (10.62)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePostoperative follow-up\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17 (10.62)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e\u003cb\u003eQ7. Have you received any professional support for the complaints that you have experienced? (multiple choice avaliable)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eResponse (n\u0026thinsp;=\u0026thinsp;133)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e98 (73.68)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLifestyle modifications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29 (21.80)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePhysical therapy modalities (Massage, TENS, dry needling, hot-cold compress, stretching)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (16.54)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedical treatment(s)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (9.77)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (2.25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e\u003cb\u003eQ8. Do/Does your complaint(s) affect your choice of radical prostatectomy technique\u003c/b\u003e?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eResponse (n\u0026thinsp;=\u0026thinsp;133)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0.75)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUsually\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (10.52)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (6.76)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58 (43.6)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26 (19.54)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI can perform only one type of technique\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (18.79)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003eBMI, body-mass index; SD, standard deviation; TENS, transcutaneous electrical nerve stimulation\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003e*Multiple responses available\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eConsidering the preferred surgical technique, the mean age and BMI of the participants were similar (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). RALP group showed better physical exhaustion than LRP and ORP groups (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). However, RALP group declared higher risk of eye-strain (p\u0026thinsp;=\u0026thinsp;0.002), whereas all other complaints were similar between groups (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Most of the surgeons preferred walking among the sportive activities (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e and Supplemental Table\u0026nbsp;1).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic data and analysis of responses to questions 5 and 6 between groups.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOpen RP\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;127)\u003c/p\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003cp\u003eMedian (min-max)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLaparoscopic RP\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;58)\u003c/p\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003cp\u003eMedian (min-max)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRobot-assisted RP\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;37)\u003c/p\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003cp\u003eMedian (min-max)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (year)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45.83\u0026thinsp;\u0026plusmn;\u0026thinsp;0.87\u003c/p\u003e \u003cp\u003e45 (29\u0026ndash;71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44.24\u0026thinsp;\u0026plusmn;\u0026thinsp;1.17\u003c/p\u003e \u003cp\u003e43 (29\u0026ndash;65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45.70\u0026thinsp;\u0026plusmn;\u0026thinsp;1.76\u003c/p\u003e \u003cp\u003e43 (29\u0026ndash;76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.555\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26.97\u0026thinsp;\u0026plusmn;\u0026thinsp;0.97\u003c/p\u003e \u003cp\u003e26.89 (20.04\u0026ndash;35.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26.55\u0026thinsp;\u0026plusmn;\u0026thinsp;0.41\u003c/p\u003e \u003cp\u003e26.22 (19.83\u0026ndash;36.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27.19\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59\u003c/p\u003e \u003cp\u003e27.47 (20.04\u0026ndash;34.63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.683\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eQ5. How much does/do the preferred technique(s) exhaust you physically?\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eOpen RP\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(n\u0026thinsp;=\u0026thinsp;127)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eMedian (min-max)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eLaparoscopic RP\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(n\u0026thinsp;=\u0026thinsp;58)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eMedian (min-max)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eRobot-assisted RP\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(n\u0026thinsp;=\u0026thinsp;37)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eMedian (min-max)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eP\u003c/b\u003e \u003cb\u003evalue\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnswers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.85\u0026thinsp;\u0026plusmn;\u0026thinsp;2.32 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e5 (0\u0026ndash;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.10\u0026thinsp;\u0026plusmn;\u0026thinsp;2.62 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e5 (0\u0026ndash;9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.89 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e2 (0\u0026ndash;8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eQ6. Which of these complaints do you experience during or after performing radical prostatectomy with the preferred technique(s) ?\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eOpen RP\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(n\u0026thinsp;=\u0026thinsp;127)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eMedian (min-max)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eLaparoscopic RP\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(n\u0026thinsp;=\u0026thinsp;58)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eMedian (min-max)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eRobot-assisted RP\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(n\u0026thinsp;=\u0026thinsp;37)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eMedian (min-max)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eP\u003c/b\u003e \u003cb\u003evalue\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eForehead pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.88\u0026thinsp;\u0026plusmn;\u0026thinsp;1.66\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.17\u0026thinsp;\u0026plusmn;\u0026thinsp;2.18\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.54\u0026thinsp;\u0026plusmn;\u0026thinsp;2.30\u003c/p\u003e \u003cp\u003e1 (0\u0026ndash;9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.108\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEye strain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.82\u0026thinsp;\u0026plusmn;\u0026thinsp;1.63 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.53\u0026thinsp;\u0026plusmn;\u0026thinsp;2.22 \u003csup\u003ea, b\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.16\u0026thinsp;\u0026plusmn;\u0026thinsp;2.58 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.001 *\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeck pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.17\u0026thinsp;\u0026plusmn;\u0026thinsp;2.72\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.21\u0026thinsp;\u0026plusmn;\u0026thinsp;2.61\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.19\u0026thinsp;\u0026plusmn;\u0026thinsp;2.50\u003c/p\u003e \u003cp\u003e1 (0\u0026ndash;8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.861\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBack pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.53\u0026thinsp;\u0026plusmn;\u0026thinsp;2.80\u003c/p\u003e \u003cp\u003e2 (0\u0026ndash;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.83\u0026thinsp;\u0026plusmn;\u0026thinsp;2.78\u003c/p\u003e \u003cp\u003e3 (0\u0026ndash;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.84\u0026thinsp;\u0026plusmn;\u0026thinsp;2.67\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.170\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eShoulder stiffness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.20\u0026thinsp;\u0026plusmn;\u0026thinsp;2.33\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.79\u0026thinsp;\u0026plusmn;\u0026thinsp;2.62\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.35\u0026thinsp;\u0026plusmn;\u0026thinsp;2.12\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.252\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChest pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.39\u0026thinsp;\u0026plusmn;\u0026thinsp;1.08\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.50\u0026thinsp;\u0026plusmn;\u0026thinsp;1.60\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.30\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.551\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eArm pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.50\u0026thinsp;\u0026plusmn;\u0026thinsp;2.46\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.74\u0026thinsp;\u0026plusmn;\u0026thinsp;2.80\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.81\u0026thinsp;\u0026plusmn;\u0026thinsp;1.61\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.436\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eForearm pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.06\u0026thinsp;\u0026plusmn;\u0026thinsp;2.26\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.07\u0026thinsp;\u0026plusmn;\u0026thinsp;2.14\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.81\u0026thinsp;\u0026plusmn;\u0026thinsp;1.72\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.880\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElbow stiffness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.51\u0026thinsp;\u0026plusmn;\u0026thinsp;1.51\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.90\u0026thinsp;\u0026plusmn;\u0026thinsp;2.06\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.89\u0026thinsp;\u0026plusmn;\u0026thinsp;2.17\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.432\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHand pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.22\u0026thinsp;\u0026plusmn;\u0026thinsp;2.16\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.90\u0026thinsp;\u0026plusmn;\u0026thinsp;1.83\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.86\u0026thinsp;\u0026plusmn;\u0026thinsp;2.80\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.164\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWrist stiffness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.98\u0026thinsp;\u0026plusmn;\u0026thinsp;2.04\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.09\u0026thinsp;\u0026plusmn;\u0026thinsp;2.1\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.38\u0026thinsp;\u0026plusmn;\u0026thinsp;2.53\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.501\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFinger numbness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.11\u0026thinsp;\u0026plusmn;\u0026thinsp;2.11\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.78\u0026thinsp;\u0026plusmn;\u0026thinsp;2.62\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.86\u0026thinsp;\u0026plusmn;\u0026thinsp;2.94\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.170\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeg pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.83\u0026thinsp;\u0026plusmn;\u0026thinsp;2.78\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.43\u0026thinsp;\u0026plusmn;\u0026thinsp;2.97\u003c/p\u003e \u003cp\u003e1 (0\u0026ndash;9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.32\u0026thinsp;\u0026plusmn;\u0026thinsp;2.29\u003c/p\u003e \u003cp\u003e0 (0\u0026ndash;9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.270\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal Complaints\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.97\u0026thinsp;\u0026plusmn;\u0026thinsp;27.42\u003c/p\u003e \u003cp\u003e10 (0\u0026ndash;97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.03\u0026thinsp;\u0026plusmn;\u0026thinsp;18.84\u003c/p\u003e \u003cp\u003e14.50 (0\u0026ndash;83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.45\u0026thinsp;\u0026plusmn;\u0026thinsp;17.87\u003c/p\u003e \u003cp\u003e13 (0\u0026ndash;60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.223\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eBMI, body-mass index; RP, radical prostatectomy, SD, standard deviation,\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cb\u003e*\u003c/b\u003e Significant p values,\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003e\u003cb\u003ea, b, c\u003c/b\u003e\u003c/sup\u003e Different lowercases denote statistically significant differences.\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e- Visual analog scale (0\u0026ndash;10) was used to score for the complaints.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFrequency of weekly excercise in response to question 9.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0/week\u003c/p\u003e \u003cp\u003en,\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1/week\u003c/p\u003e \u003cp\u003en,\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2/week\u003c/p\u003e \u003cp\u003en,\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3/week n,\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4/week\u003c/p\u003e \u003cp\u003en,\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5/week\u003c/p\u003e \u003cp\u003en,\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6/week\u003c/p\u003e \u003cp\u003eNn,\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e7/week\u003c/p\u003e \u003cp\u003en,\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWalking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45 (28.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003cp\u003e(6.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21\u003c/p\u003e \u003cp\u003e(13.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e29\u003c/p\u003e \u003cp\u003e(18.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e13\u003c/p\u003e \u003cp\u003e(8.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e16\u003c/p\u003e \u003cp\u003e(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e6\u003c/p\u003e \u003cp\u003e(3.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e20\u003c/p\u003e \u003cp\u003e(12.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRunning\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e115\u003c/p\u003e \u003cp\u003e(71.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003cp\u003e(8.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003cp\u003e(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e16\u003c/p\u003e \u003cp\u003e(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4\u003c/p\u003e \u003cp\u003e(2.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e(0.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e2\u003c/p\u003e \u003cp\u003e(1.25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBicycling\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e132\u003c/p\u003e \u003cp\u003e(82.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003cp\u003e(6.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003cp\u003e(3.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003cp\u003e(1.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4\u003c/p\u003e \u003cp\u003e(2.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2\u003c/p\u003e \u003cp\u003e(1.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e(0.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e2\u003c/p\u003e \u003cp\u003e(1.25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSwimming\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e136\u003c/p\u003e \u003cp\u003e(85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003cp\u003e(4.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003cp\u003e(3.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003cp\u003e(1.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2\u003c/p\u003e \u003cp\u003e(1.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3\u003c/p\u003e \u003cp\u003e(1.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e3\u003c/p\u003e \u003cp\u003e(1.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e(0.62)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFootball\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e148\u003c/p\u003e \u003cp\u003e(92.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003cp\u003e(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003cp\u003e(1.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e(0.62)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBasketball\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e151\u003c/p\u003e \u003cp\u003e(94.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003cp\u003e(2.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003cp\u003e(2.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e(0.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVolleyball\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e156\u003c/p\u003e \u003cp\u003e(97.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003cp\u003e(1.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003cp\u003e(1.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTennis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e154\u003c/p\u003e \u003cp\u003e(96.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003cp\u003e(2.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e(0.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e(0.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGolf\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e157\u003c/p\u003e \u003cp\u003e(98.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e(0.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e(0.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e(0.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeight Lifting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e136\u003c/p\u003e \u003cp\u003e(85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003cp\u003e(1.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003cp\u003e(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003cp\u003e(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2\u003c/p\u003e \u003cp\u003e(1.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2\u003c/p\u003e \u003cp\u003e(1.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e(0.62)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBoxing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e154\u003c/p\u003e \u003cp\u003e(96.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e(0.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003cp\u003e(1.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003cp\u003e(1.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMeditation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e151\u003c/p\u003e \u003cp\u003e(94.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003cp\u003e(1.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003cp\u003e(1.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e(0.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2\u003c/p\u003e \u003cp\u003e(1.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYoga\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e153\u003c/p\u003e \u003cp\u003e(95.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003cp\u003e(1.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003cp\u003e(1.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003cp\u003e(1.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e(0.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePilates\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e155\u003c/p\u003e \u003cp\u003e(96.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003cp\u003e(1.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e(0.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e2\u003c/p\u003e \u003cp\u003e(1.25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eMany conditions may cause stress on surgeons, including patient-related, work-related, social and self-related factors.\u003csup\u003e12\u003c/sup\u003e Major surgeries using minimally invasive techniques may in itself be one of the main causes of increased stress on surgeons. It is well-known that increased stress factor may negatively affect the surgical outcomes and cntrolling stress factors can increase surgical success.\u003csup\u003e10\u003c/sup\u003e A report from Turkey showed that gradual increase of stressful situations could cause psychological deterioration and a consequent burnout syndrome that is quite common in urologists in Turkey.\u003csup\u003e8\u003c/sup\u003e Minimally invasive methods are more beneficial for patients but do not always provide an ergonomic convenience for surgeons. \u003csup\u003e13\u003c/sup\u003e Despite its minimally invasive nature, laparoscopy can cause surgeon discomfort due to posture, vision, and instrumentation limitations.\u003c/p\u003e \u003cp\u003eMorbid obesity one of the reasons that may cause greater stress to surgeons by increasing the risk of intra-operative and postoperative complications. Consistent with previous reports, our results showed that 71.25% of surgeons are stressed due to obesity-related complications when performing radical prostatectomy.Contrary to these reports, Eden et al. stated that obesity only increased operative time for laparoscopic prostatectomy but did not impact other intraoperative and postoperative surgical parameters, possibly due to high number of surgical experience.\u003csup\u003e14\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eOur results regarding the relationship between physical complaints and exercise showed that regular physical activity improved some physical complaints such as elbow stiffness, hand and leg pain, and finger numbness, although low number of participants. Laparoscopy is related to suboptimal static posture. A study investigating the effects of the ETHOS surgical chair, three-dimensional technology, and Radius Surgical System manipulators on surgical time and surgeon comfort reported a similar surgical time and comfort rate to the da Vinci technique compared to the classical laparoscopic method. \u003csup\u003e15\u003c/sup\u003e Despite a report advocating that the RALP was a user-friendly interface due to 3D vision, Lee et al. reported that 56.1% of surgeons experienced physical discomfort.\u003csup\u003e16\u003c/sup\u003e Similar to that report, Tokas commented that LRP caused distress in the upper back, shoulders, arms, and wrist, but RALP was associated with higher discomfort in the forehead, neck, and trunk. \u003csup\u003e17\u003c/sup\u003e This finding supports our hypothesis regarding the RALP could cause less physical exhaustion and musculoskeletal complaints than the other techniques.\u003csup\u003e18\u003c/sup\u003e Among open, laparoscopic and robot-assisted radical prostatectomy techniques, the RALP technique was related to lower physical exhaustion, possibly due to it is performed in a sitting position, provides a 3-dimensional view and is associated with much more comfortable hand and wrist movements.\u003csup\u003e7, 19\u003c/sup\u003e A report was published comparing robotic surgery and conventional laparoscopy on the muscle groups that surgeons use most frequently during surgery, and the authors stated that robotic-assisted laparoscopic surgery was more advantageous than conventional laparoscopy in experienced hands. \u003csup\u003e19\u003c/sup\u003e The results of a meta-analysis investigating the effects of exercise on the locomotor system showed that regular activity or exercise was beneficial in individuals with chronic musculoskeletal pain .\u003csup\u003e20\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eStudies conducted to complete the learning curve showed that 30\u0026ndash;50 consecutive cases would be sufficient for robotic or laparoscopic surgery.\u003csup\u003e21, 22\u003c/sup\u003e In our study, the majority of the participants had experience of up to 100 cases for all three different prostatectomy techniques. In accordance with the literature, our finding on physical strain showed that surgeons performing RALP experienced an increase in eye strain, while other complaints were similar. \u003csup\u003e23\u003c/sup\u003e Our findings support that the RALP technique is superior to the other techniques when physical strain is taken into consideration. Significant ergonomic problems, especially finger numbness and eye strain may more likely occur during laparoscopic surgery and younger surgeons tend to be more affected. Hemal et al. concluded in their study that surgeons performing a laparoscopy have significant ergonomic problems, especially finger numbness and eye strain, and younger laparoscopic surgeons were more affected\u003csup\u003e4\u003c/sup\u003e. Matern et al. reported that muscle strength applied during the use of laparoscopic instruments might increase up to six-fold greater compared to open surgery.\u003csup\u003e24\u003c/sup\u003e Despite this challenging aspect of laparoscopic surgery, our results showed that 63.14% of surgeons did not change their choice of radical prostatectomy technique. One of the remarkable findings of this study is that while only 18.79% of surgeons used only one prostatectomy technique, majority of the participants were willing to new surgical techniques.\u003c/p\u003e \u003cp\u003eOne of the remarkable findings of this study is that while only 18.79% of surgeons used only one prostatectomy technique, majority of the participants were willing to new surgical techniques. This finding might be a reason for likelihood of increased exhaustion until learning curve has been completed. One of the remarkable findings of this study is that while only 18.79% of surgeons used only one prostatectomy technique, majority of the participants were willing to new surgical techniques. This finding might be a reason for likelihood of increased exhaustion until learning curve has been completed. Indeed, considering that all groups had an experience up to 100 cases per year, physical exhaustion rate was significantly lower in robotic arm than the others possibly due to better ergonomy and three-D vision advantages.\u003c/p\u003e \u003cp\u003eIn this study, majority of urologists preferred walking. There was a slight correlation between regular physical activity and reduced musculoskeletal complaints in surgeons who performed radical prostatectomy. Fitness exercise can be a solution for avoiding and maybe buffering the musculoskeletal strain during the operation.\u003csup\u003e25\u003c/sup\u003e Some authors stated that regular sportive activity might be protective from exhausting.\u003csup\u003e26\u003c/sup\u003e A relationship between insufficient exercise and chronic diseases has been described. \u003csup\u003e27\u003c/sup\u003e A meta-analytical study shoed that regular and adequate exercise positively affected various musculoskeletal complaints without the additional treatment cost. \u003csup\u003e28\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eIn a web-based survey study conducted among 701 urologists worldwide, walking and running were found to be the most common types of exercise, similar to our results, and the protective effect of exercise on development of low back pain was demonstrated. \u003csup\u003e29\u003c/sup\u003e Urologists performing regular exercise or sportive activities face lower physical exhaustion and musculoskeletal complaints that support our hypothesis. We believe that encouraging urologists dealing with LRP and RALP to engage in regular sportive activities would help to improve physical discomfort.\u003c/p\u003e \u003cp\u003eSeveral factors limit the strength of this study, including lack of assessment of comorbidities, level of experience in the profession, monthly income levels, and relatively low number of participants.\u003c/p\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eThis study concluded that the RALP technique caused less physical exhaustion than the ORP and LRP techniques. Further comprehensive studies with larger participants are needed to validate these results. Although regular exercise weakly improved physical exhaustion and musculoskeletal complaints, we believe that encouraging urologists dealing with LRP and RALP to engage in regular sportive activities would help to improve physical discomfort.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eBMI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ebody mass index\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLRP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003elaparoscopic radical prostatectomy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eORP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eopen radical prostatectomy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRALP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003erobot-assisted laparoscopic prostatectomy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eQ\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003equestion.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInstitutional Review Board \u0026nbsp;Training and Research Hospital (Approval no: 2019-023).\u0026nbsp;\u003cstrong\u003eInformed consent to participate was sent \u0026nbsp;to all urologists via e-email. \u0026nbsp;In informed consent the aim of survey was clarified. Informed consent was obtained from all participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAuthors declare that there is no conflict of interest.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStudy design: M.T.O and A.S.G. ; Coordination: Y.O, M.T.O. M.S.B.; Data gathering: M.T.O., K.Y., M.S.B.; Data analysis:M.T.O. , M.S.B. and K.Y..; Interpretation of results: M.T.O , A.S.G and M.S.B. ; Drafting the manuscript: M.T.O :M.S.B ,A.S.G and T.T.; Final revision of the manuscripts: A.S.G , Y.O \u0026nbsp;and T.T. All authors have read and approved the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAs authors, we would like to thank the Turkish Association of Urology, Turkish Endourology Society, Turkurolap Education and Research Group for their support in reaching out to member of urologists.\u003c/strong\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWalsh PC, Donker PJ. Impotence following radical prostatectomy: insight into etiology and prevention. J Urol. 1982;128:492\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWw S, Kavoussi LR, Clayman RV, Vancaillie TH. Laparoscopic radical prostatectomy: initial case report. J Urol. 1992;147:246A.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGofrit ON, Mikahail AA, Zorn KC, Zagaja GP, Steinberg GD, Shalhav AL. Surgeons\u0026rsquo; perceptions and injuries during and after urologic laparoscopic surgery. Urology. 2008;71:404\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHemal A, Srinivas M, Charles A. Ergonomic problems associated with laparoscopy. J Endourol. 2001;15:499\u0026ndash;503.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePasticier G, Rietbergen JB, Guillonneau B, Fromont G, Menon M, Vallancien G. Robotically assisted laparoscopic radical prostatectomy: feasibility study in men. Eur Urol. 2001;40:70\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBagrodia A, Raman JD. Ergonomic considerations of radical prostatectomy: physician perspective of open, laparoscopic, and robot-assisted techniques. J Endourol. 2009;23:627\u0026ndash;33.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAndolfi C, Kumar R, Boysen WR, Gundeti MS. Current Status of Robotic Surgery in Pediatric Urology. J Laparoendosc Adv Surg Tech A. 2019;29:159\u0026ndash;66.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBolat MS, Yuruk E, Cinar O, Akdeniz E, Altunrende F, Ozkuvanci U, et al. The prevalence of Burnout Syndrome among Turkish Urologists: Results of a Nationwide Survey. Turk J Urol. 2019;45:449\u0026ndash;55.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWewege MA, Thom JM, Rye KA, Parmenter BJ. Aerobic, resistance or combined training: A systematic review and meta-analysis of exercise to reduce cardiovascular risk in adults with metabolic syndrome. Atherosclerosis. 2018;274:162\u0026ndash;71.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCheville AL, Smith SR, Basford JR. Rehabilitation Medicine Approaches to Pain Management. Hematol Oncol Clin N Am. 2018;32:469\u0026ndash;82.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRosenbaum S, Sherrington C. Is exercise effective in promoting mental well-being in older age? A systematic review. Br J Sports Med. 2011;45:1079\u0026ndash;80.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArora S, Sevdalis N, Nestel D, Woloshynowych M, Darzi A, Kneebone R. The impact of stress on surgical performance: a systematic review of the literature. Surgery. 2010;147:318\u0026ndash;30. 330 e311-316.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRenda A, Vallancien G. Principles and advantages of robotics in urologic surgery. Curr Urol Rep. 2003;4:114\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEden CG, Chang CM, Gianduzzo T, Moon DA. The impact of obesity on laparoscopic radical prostatectomy. BJU Int. 2006;98:1279\u0026ndash;82.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTokas T, Gozen AS, Avgeris M, Tschada A, Fiedler M, Klein J, et al. Combining of ETHOS Operating Ergonomic Platform, Three-dimensional Laparoscopic Camera, and Radius Surgical System Manipulators Improves Ergonomy in Urologic Laparoscopy: Comparison with Conventional Laparoscopy and da Vinci in a Pelvi Trainer. Eur Urol focus. 2017;3:413\u0026ndash;20.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLee GI, Lee MR, Green I, Allaf M, Marohn MR. Surgeons' physical discomfort and symptoms during robotic surgery: a comprehensive ergonomic survey study. Surg Endosc. 2017;31:1697\u0026ndash;706.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTokas T. Comment on: Surgeons' posture and muscle strain during laparoscopic and robotic surgery. Br J Surg. 2020;107:e282.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRassweiler J, Hruza M, Klein J, Goezen AS, Teber D. The role of laparoscopic radical prostatectomy in the era of robotic surgery. Eur Urol Supplements. 2010;9:379\u0026ndash;87.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDalager T, S\u0026oslash;gaard K, Bech KT, Mogensen O, Jensen PT. Musculoskeletal pain among surgeons performing minimally invasive surgery: a systematic review. Surg Endosc. 2017;31:516\u0026ndash;26.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eO'Connor SR, Tully MA, Ryan B, Bleakley CM, Baxter GD, Bradley JM, et al. Walking exercise for chronic musculoskeletal pain: systematic review and meta-analysis. Arch Phys Med Rehabil. 2015;96:724\u0026ndash;34. e723.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMenon M, Shrivastava A, Tewari A, Sarle R, Hemal A, et al. Laparoscopic and robot assisted radical prostatectomy: establishment of a structured program and preliminary analysis of outcomes. J Urol. 2002;168:945\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFabrizio MD, Tuerk I, Schellhammer PF. Laparoscopic radical prostatectomy: decreasing the learning curve using a mentor initiated approach. J Urol. 2003;169:2063\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePlerhoples TA, Hernandez-Boussard T, Wren SM. The aching surgeon: a survey of physical discomfort and symptoms following open, laparoscopic, and robotic surgery. J Robot Surg. 2012;6:65\u0026ndash;72.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMatern U, Waller P. Instruments for minimally invasive surgery: principles of ergonomic handles. Surg Endosc. 1999;13:174\u0026ndash;82.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSchlussel AT, Maykel JA. Ergonomics and Musculoskeletal Health of the Surgeon. Clin Colon Rectal Surg. 2019;32:424\u0026ndash;34.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDe Hert S. Burnout in Healthcare Workers: Prevalence, Impact and Preventative Strategies. Local Reg Anesth. 2020;13:171\u0026ndash;83.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBooth FW, Roberts CK, Laye MJ. Lack of exercise is a major cause of chronic diseases. Compr Physiol. 2012;2:1143\u0026ndash;211.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMiyamoto GC, Lin CC, Cabral CMN, van Dongen JM, van Tulder MW. Cost-effectiveness of exercise therapy in the treatment of non-specific neck pain and low back pain: a systematic review with meta-analysis. Br J Sports Med. 2019;53:172\u0026ndash;81.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLloyd GL, Chung ASJ, Steinberg S, Sawyer M, Williams DH, Overbey D. Is Your Career Hurting You? The Ergonomic Consequences of Surgery in 701 Urologists Worldwide. J Endourol. 2019;33:1037\u0026ndash;42.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Ergonomy, Laparoscopy, Open surgery, Radical Prostatectomy, Robotics","lastPublishedDoi":"10.21203/rs.3.rs-3976248/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3976248/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eOblective\u003c/h2\u003e \u003cp\u003eIn this web-based international survey study, we aimed to show association between physical exhaustion, and patient, relatives, and employers-related mental stress on surgeons performing open radical prostatectomy (ORP), laparoscopic radical prostatectomy (LRP), and robot-assisted laparoscopic prostatectomy (RALP) .\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA ten-question survey was sent to the urologists performing ORP, LRP, and RALP via e-mail and social media platforms. The techniques preferred by the participants and their possible associations with physical exhaustion, musculoskeletal complaints and stress caused by patients\u0026rsquo; or patients\u0026rsquo; relatives or employers\u0026rsquo; expectations as well as regular exercise or sportive activities were investigated.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA total of 160 urologists completed the survey. RALP group showed lower physical exhaustion rate and increased eye-strain (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001 and p\u0026thinsp;=\u0026thinsp;0.002, respectively). Although walking was the most preferred sportive activity, no correlation was found between regular sport or exercise and musculoskeletal complaints (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eLower physical exhaustion was achieved in RALP technique compared to ORP and LRP. Although the number of participants limited, regular exercise weakly improved physical exhaustion and musculoskeletal complaints. We believe that encouraging the urologists dealing with LRP and RALP to force regular sportive activities would help to improve physical discomfort.\u003c/p\u003e","manuscriptTitle":"Physical and mental effects of different radical prostatectomy techniques on urologic surgeons","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-13 06:43:56","doi":"10.21203/rs.3.rs-3976248/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"977b1c67-e0b2-4853-9d53-0e687b700be9","owner":[],"postedDate":"March 13th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-04-09T09:58:31+00:00","versionOfRecord":[],"versionCreatedAt":"2024-03-13 06:43:56","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3976248","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3976248","identity":"rs-3976248","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}