scholarly journals Preoperative MRI Parameters Predict Urinary Continence after Robot-Assisted Laparoscopic Prostatectomy in Prostatic Cancer Patients

Diagnostics ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 102 ◽  
Author(s):  
Shinji Fukui ◽  
Yoriaki Kagebayashi ◽  
Yusuke Iemura ◽  
Yoshiaki Matsumura ◽  
Shoji Samma
Keyword(s):  
Urinary Incontinence ◽  
Radical Prostatectomy ◽  
Bladder Neck ◽  
Prostatic Cancer ◽  
Pubic Symphysis ◽  
Urinary Continence ◽  
Robot Assisted ◽  
Mri Findings ◽  
Postoperative Observation ◽  
Lower Group

We aimed to investigate whether preoperative MRI findings could predict the bladder neck location on postoperative cystography and recovery of urinary incontinence after robot-assisted laparoscopic radical prostatectomy (RALP). We retrospectively reviewed 270 consecutive patients who had complete preoperative data, including MRI, and underwent postoperative observation for more than three months. Preoperative MRI parameters consisted of the membranous urethral length (MUL) and pubic symphysis-prostate apex length (PAL) on sagittal images. The bladder neck location on a postoperative cystography was defined as the lowest extension of the tapering contrast medium in the bladder, and its relation to the pubic symphysis (above (higher group) and below (lower group) the middle of the pubic symphysis height) was evaluated. Those who required no pad or a safety pad were defined as being continent. PAL was significantly shorter in the higher group than that in the lower group (25.5 vs. 29.1 mm; p < 0.0001). The continent group at three months had a significantly longer MUL and shorter PAL than those in the incontinent group (8.1 vs. 6.7 mm; p < 0.05, and 26.0 vs. 28.1 mm; p < 0.05, respectively). Preoperative MRI parameters could predict the bladder neck location on postoperative cystograms and the recovery of urinary incontinence after RALP.

The Impact of Lateral Bladder Neck Preservation on Urinary Continence Recovery After Robot-Assisted Radical Prostatectomy

2018 ◽  
Vol 32 (1) ◽  
pp. 40-45 ◽  
Author(s):  
Takeshi Hashimoto ◽  
Kunihiko Yoshioka ◽  
Tatsuo Gondo ◽  
Kazuki Hasama ◽  
Yosuke Hirasawa ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Bladder Neck ◽  
Urinary Continence ◽  
Robot Assisted ◽  
Neck Preservation ◽  
The Impact

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.

Bladder Neck Sling Suspension During Robot-assisted Radical Prostatectomy to Improve Early Return of Urinary Continence: A Comparative Analysis

Urology ◽  
2014 ◽  
Vol 83 (3) ◽  
pp. 632-640 ◽  
Author(s):  
Yoshiyuki Kojima ◽  
Takashi Hamakawa ◽  
Yasue Kubota ◽  
Soichiro Ogawa ◽  
Nobuhiro Haga ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Radical Prostatectomy ◽  
Bladder Neck ◽  
Urinary Continence ◽  
Robot Assisted ◽  
Early Return

Bladder Neck Plication Stitch: A Novel Technique During Robot-Assisted Radical Prostatectomy to Improve Recovery of Urinary Continence

2011 ◽  
Vol 25 (12) ◽  
pp. 1873-1877 ◽  
Author(s):  
David I. Lee ◽  
Alexei Wedmid ◽  
Pierre Mendoza ◽  
Saurabh Sharma ◽  
Mary Walicki ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Bladder Neck ◽  
Urinary Continence ◽  
Robot Assisted ◽  
Novel Technique

Relative position of bladder neck to pubic symphysis on cystogram is a strong and reproducible predictor of early urinary continence recovery following radical prostatectomy

2020 ◽  
pp. 039156032097489
Author(s):  
Marta Rossanese ◽  
Simona Caloggero ◽  
Giuseppe Alario ◽  
Giuseppe Mucciardi ◽  
Giacomo Novara ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Relative Position ◽  
Bladder Neck ◽  
Interobserver Agreement ◽  
Multivariable Analysis ◽  
Pubic Symphysis ◽  
Urinary Continence ◽  
Validated Questionnaire ◽  
Expert Surgeon ◽  
Two Parameters

Objectives: To assess whether bladder neck angle and position on cystogram predict early urinary continence in patients scheduled for early catheter removal after radical prostatectomy (RP). Methods: A total of 103 patients undergoing open or robot-assisted RP by one expert surgeon between January and December 2019 were retrospectively analyzed. A cystogram was performed on postoperative day 3 or 4 to evaluate anastomotic leakage, and, if none or minimal, the catheter was removed. Urinary continence was evaluated with a validated questionnaire at 1 week, 1 month, and 3 months after RP. Four investigators of different experience assigned bladder neck angle and relative position of bladder neck to pubic symphysis on archived cystogram images. Association between these two parameters and urinary continence rates at different follow-up times was assessed with logistic regression analysis adjusting for patient and tumor characteristics, and surgical technique. Interobserver agreement in assigning the two parameters was measured with k statistic. Results: Catheter was removed immediately after cystogram in 101 (98%) patients. On multivariable analysis, only relative position of bladder neck to pubic symphysis was an independent predictor of 1-week (odds ratio [OR] 30. 95% confidence intervals [CIs] 6-138, p < 0.001), 1-month (OR 11. 95%CIs 3.8-32, p < 0.001), and 3-month (OR 19. 95%CIs 3.6-98, p < 0.001) urinary continence. Interobserver agreement for bladder neck and relative position of bladder neck to pubic symphysis was fair to moderate, and substantial to almost perfect, respectively. Conclusions: Relative position of bladder neck to pubic symphysis on cystogram is a strong and reproducible predictor of early urinary continence after RP.

PD15-03 RANDOMIZED CLINICAL TRIAL EXAMINING THE RETURN OF URINARY CONTINENCE AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY WITH OR WITHOUT A BLADDER NECK SLING

2015 ◽  
Vol 193 (4S) ◽  
Author(s):  
Chandru P. Sundaram ◽  
Clinton D. Bahler ◽  
Steven M. Lucas ◽  
Naveen Kella ◽  
Thomas A. Gardner ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Radical Prostatectomy ◽  
Randomized Clinical Trial ◽  
Bladder Neck ◽  
Urinary Continence ◽  
Robot Assisted
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