Use of preoperative factors including urodynamic evaluations and nerve-sparing status for predicting urinary continence recovery after robot-assisted radical prostatectomy: Nerve-sparing technique contributes to the reduction of postprostatectomy incontin

2015 ◽  
Vol 35 (8) ◽  
pp. 1034-1039 ◽  
Author(s):  
Yoshifumi Kadono ◽  
Satoru Ueno ◽  
Suguru Kadomoto ◽  
Hiroaki Iwamoto ◽  
Yuta Takezawa ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Urinary Continence ◽  
Nerve Sparing ◽  
Robot Assisted ◽  
Preoperative Factors

scholarly journals Detrusorrhaphy during Robot-Assisted Radical Prostatectomy: Early Recovery of Urinary Continence and Surgical Technique

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Tae Young Shin ◽  
Yong Seong Lee
Keyword(s):  
Urinary Incontinence ◽  
Radical Prostatectomy ◽  
Intraoperative Complications ◽  
Risk Groups ◽  
Catheter Removal ◽  
Urinary Continence ◽  
Nerve Sparing ◽  
Robot Assisted ◽  
Early Recovery ◽  
Open Radical Prostatectomy

Robot-assisted radical prostatectomy (RARP) has largely replaced open radical prostatectomy as the standard surgical treatment for prostate cancer. However, postoperative urinary incontinence still persists and has a significant impact on quality of life. We report the superior results of the detrusorrhaphy technique during RARP that helps achieve early continence. Our prospective study involved 95 consecutive patients who underwent RARP between March 2015 and May 2017; fifty patients underwent RARP using the new detrusorrhaphy technique (group 1) and 45 underwent standard RARP (group 2). The postoperative oncological and functional outcomes were compared between the two groups. The postoperative continence was assessed at 0 day, 1 week, 4 weeks, 8–12 weeks, and 6 months after catheter removal. Continence was defined as the use of no pad over a 24 h period. Mean operative time in groups 1 and 2 were 250 and 220 min, respectively. Intraoperative complications were not encountered in any patient. The continence rates after catheter removal in groups 1 and 2 were 68% and 0% at 0 day, 78% and 17.8% at 1 week, 86% and 64.4% at 4 weeks, 92% and 73.3% at 8–12 weeks, and 100% and 91.1% at 6 months, respectively. In the multivariate analysis, the nerve sparing technique, D’Amico risk groups, and prostate volume were involved in the early recovery of urinary continence. The detrusorrhaphy technique is simple, safe, and feasible, which helped achieve earlier continence. It showed significantly better outcomes than those achieved with the standard RARP technique in terms of urinary incontinence. Nevertheless, our findings need to be validated in further studies.

V8-07 MODIFIED MILAN SLING TECHNIQUE DURING ROBOT-ASSISTED RADICAL PROSTATECTOMY FOR EARLY RECOVERY OF URINARY CONTINENCE WITHOUT NERVE-SPARING: A PILOT STUDY

2017 ◽  
Vol 197 (4S) ◽  
Author(s):  
Yuji MAEDA ◽  
Toshimitsu MISAKI ◽  
Osamu UEKI ◽  
Tetsuyuki KUROKAWA ◽  
Yukinosuke OSHINOYA ◽  
...  
Keyword(s):  
Pilot Study ◽  
Radical Prostatectomy ◽  
Urinary Continence ◽  
Nerve Sparing ◽  
Robot Assisted ◽  
Early Recovery

scholarly journals Predictors of early continence following robot-assisted radical prostatectomy

2015 ◽  
Vol 9 (1-2) ◽  
pp. 93 ◽  
Author(s):  
Hugo Lavigueur-Blouin ◽  
Alina Camacho Noriega ◽  
Roger Valdivieso ◽  
Pierre-Alain Hueber ◽  
Marc Bienz ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Specific Antigen ◽  
Maximal Activity ◽  
Urinary Continence ◽  
Nerve Sparing ◽  
Robot Assisted ◽  
Prostate Weight ◽  
Increased Risk ◽  
Patient Reported

Introduction: Functional outcomes after robot-assisted radical prostatectomy (RARP) greatly influence patient quality of life. Data regarding predictors of early continence, especially 1 month following RARP, are limited. Previous reports mainly address immediate or 3-month postoperative continence rates. We examine preoperative predictors of pad-free continence recovery at the first follow-up visit 1 month after RARP.Methods: Between January 2007 and January 2013, preoperative and follow-up data were prospectively collected for 327 RARP patients operated on by 2 fellowship-trained surgeons (AEH and KCZ). Patient and operative characteristics included age, body mass index (BMI), staging, preoperative prostate-specific antigen (PSA), prostate weight, International Prostate Symptom Score (IPSS), Sexual Health Inventory for Men (SHIM) score and type of nervesparing performed. Continence was defined by 0-pad usage at 1 month follow-up. Univariate and multivariate logistic regression models were used to assess for predictors of early continence.Results: Overall, 44% of patients were pad-free 1 month post- RARP. In multivariate regression analysis, age (odds ratio [OR] 0.946, confidence interval [CI] 95%: 0.91, 0.98) and IPSS (OR: 0.953, CI 95%: 0.92, 0.99) were independent predictors of urinary continence 1 month following RARP. Other variables (BMI, staging, preoperative PSA, SHIM score, prostate weight and type of nerve-sparing) were not statistically significant predictors of early continence. Limitations of this study include missing data for comorbidities, patient use of pelvic floor exercises and patient maximal activity. Moreover, patient-reported continence using a 0-pad usage definition represents a semiquantitative and subjective measurement.Conclusion: In a broad population of patients who underwent RARP at our institution, 44% of patients were pad-free at 1 month. Age and IPSS were independent predictors of early continence after surgery. Men of advanced age and those with significant lower urinary tract symptoms prior to RARP should be counselled on the increased risk of urinary incontinence in the early stages.

scholarly journals Independent Factors Affecting Postoperative Short-Term Urinary Continence Recovery after Robot-Assisted Radical Prostatectomy

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Wen Deng ◽  
Ru Chen ◽  
Xian Jiang ◽  
Ping Zheng ◽  
Ke Zhu ◽  
...  
Keyword(s):  
Lymph Node ◽  
Radical Prostatectomy ◽  
Surgical Approach ◽  
Prostate Volume ◽  
Urinary Continence ◽  
Nerve Sparing ◽  
Robot Assisted ◽  
Short Term ◽  
Patient Age ◽  
Transvesical Approach

Background. Our team had firstly applied the transvesical approach to robot-assisted radical prostatectomy (RARP) in patients afflicted with localized prostate cancer (PCa). The present study aims to present the postoperative recovery of urinary continence (UC) following the anterior, transvesical, and posterior approaches to RARP for localized PCa and evaluate the independent predictors to early UC recovery after RARP. Methods. Patients harboring localized PCa and receiving anterior, transvesical, and posterior approaches to RARP between January 2017 and June 2020 were enrolled in this analysis. Results on UC recovery were compared between these three approaches with the Kaplan–Meier method. All clinical and pathological variables were further analyzed via univariable and multivariable regression analysis to determine the independent factors contributing to short-term UC recovery after RARP. Results. A total of 135, 73, and 66 instances were included in the anterior, transvesical, and posterior groups, respectively. Over the postoperative follow-up period, both the transvesical and posterior approaches showed an advantage over the anterior approach in promoting postoperative UC recovery (both p values <0.001). Three months after surgery, 55 (40.7%), 4 (5.5%), and 5 (7.6%) patients failed to UC in the anterior, transvesical, and posterior groups, respectively. Patient age, preoperative PSA, prostate volume, biopsy Gleason score, surgical approach, extended lymph node dissection technique, nerve-sparing technique, and positive lymph node were related to UC status based on univariable analyses ( p < 0.05 ). Multivariable analysis results point patient age, prostate volume, surgical approach, and nerve-sparing technique as independent factors that affect postoperative UC recovery after RARP. Conclusions. The application of transvesical approach to RARP for localized PCa could obtain promising outcomes in terms of postoperative UC recovery. In addition, surgical strategies encompassing the nerve-sparing technique and the Retzius-sparing procedures, namely, the transvesical or posterior approach, during RARP could independently enable early achievement of postoperative continence.

The applicability of patient-Specific 3D models in the planning of nerve-sparing robot-assisted radical prostatectomy

2021 ◽  
Vol 79 ◽  
pp. S1556-S1557
Author(s):  
H. Veerman ◽  
T.N. Boellaard ◽  
C. Hoeks ◽  
J.A. Van Eick ◽  
J. Sluijter ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
3D Models ◽  
Patient Specific ◽  
Nerve Sparing ◽  
Robot Assisted
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