PURPOSE: Urinary incontinence is one of the major prostate cancer treatment-related morbidities.
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We review our initial robot-assisted laparoscopic prostatectomy (RALP) experience, focusing on post-surgery continence rates.
MATERIAL AND METHODS: Two-hundred and thirty-three consecutive patients were identified from a prospectively maintained RALP database. A bladder neck sparing dissection was preferentially performed during transperitoneal RALP. On postoperative day 5 or 6 (clinic logistics), the urethral catheter was removed following a normal cystogram.
RESULTS: Median operative time was 190 minutes and estimated blood loss was 75 mL. Three (1.3%) patients required bladder neck reconstruction, while 198 (85.0%) had bilateral, 20 (8.6%) had unilateral and 15 (6.4%) did not undergo nerve sparing prostatectomy. One-hundred and ninety-nine (85.4%) patients had negative surgical margins. Median hospitalization and urethral catheter duration were 1.0 and 5.0 days, respectively. At six weeks, a median 1.0 pad per day usage was reported and mean AUASS and QoL were significantly improved from baseline (p < 0.05). Of the 220 patients having a minimum three-month follow-up, 152 (69.1%) achieved urinary continence without pads. Age, AUASS, QoL, prostate volume and prior TUR surgery independently had significant impact on early continence rate (p < 0.05).
CONCLUSION: A bladder neck sparing dissection allows for early return of urinary continence following RALP without compromising cancer control.
Gu X, Araki M, Wong C. Are you the author?
Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Reference: Minim Invasive Ther Allied Technol. 2015 Mar 22:1-8.