Continence-Sparing Techniques in Radical Prostatectomy: A Systematic Review of Randomized Controlled Trials

Ippoliti, Simona; Colalillo, Gaia; Egbury, Gerald; Orecchia, Luca; Fletcher, Peter; Piechaud, Thierry; Gaston, Richard; Finazzi-Agrò, Enrico; Miano, Roberto; Asimakopoulos, Anastasios D.

doi:10.1089/end.2023.0188

Cited by 3 publications

(1 citation statement)

References 55 publications

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“…Although RARP is a less invasive procedure in terms of bleeding or operative time, postoperative urinary incontinence is a major complication, which markedly affects the quality of life of patients 3 – 5 . Although many surgical techniques have been developed to address the issue of urinary incontinence, no methodology to avoid urinary incontinence has been established 6 – 9 .…”

Section: Discussionmentioning

confidence: 99%

Novel nerve-sparing robot-assisted radical prostatectomy with endopelvic fascia preservation and long-term outcomes for a single surgeon

Maruo,

Goto,

Miyazaki

et al. 2024

Sci Rep

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Although novel techniques for avoiding incontinence during robot-assisted radical prostatectomy have been developed, long-term oncological outcomes are unknown. The objective of this study was to determine the long-term oncological outcomes and functional outcomes of novel nerve-sparing robot-assisted radical prostatectomy with endopelvic fascia preservation for a single surgeon. Data from 100 patients who underwent structure-preserving prostatectomies performed by a single surgeon were retrospectively analyzed. The median console time was 123 min. Bilateral nerve-sparing was performed in 43% of patients underwent, and 57% underwent unilateral nerve-sparing surgery. Most patients (96%) reached complete pad-zero urinary continence by one year after surgery. Satisfactory erectile function was achieved in 97% of patients who underwent bilateral nerve-sparing surgery, and 80% of patients who underwent unilateral nerve-sparing surgery. The surgical margin was positive for 25% of patients, and the biochemical recurrence-free rate at 5 years was 77%. The cancer-specific survival rate was 100% during the median follow-up period of 4.5 years. Clavien-Dindo grade III complications occurred in 1% of cases. The outcomes for novel nerve-sparing robot-assisted radical prostatectomy with endopelvic fascia preservation were similar to previously reported oncological outcomes, with satisfactory functional outcomes. This operative method may be useful for patients who are eligible for nerve-sparing surgery.

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Section: Discussionmentioning

confidence: 99%

Novel nerve-sparing robot-assisted radical prostatectomy with endopelvic fascia preservation and long-term outcomes for a single surgeon

Maruo,

Goto,

Miyazaki

et al. 2024

Sci Rep

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The prostate-gland asymmetry affects the 3- and 12-month continence recovery after RARP in patients with small prostate glands: a single center study

Di Bello,

Morra,

Fraia

et al. 2024

J Robotic Surg

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To test the impact of the prostate-gland asymmetry on continence rates, namely 3- and 12-month continence recovery, in prostate cancer (PCa) patients who underwent robot-assisted radical prostatectomy (RARP). Within our institutional database, RARP patients with complete preoperative MRI features and 12 months follow-up were enrolled (2021–2023). The population has been stratified according to the presence or absence of prostate-gland asymmetry (defined as the presence of median lobe or side lobe dominance). Multivariable logistic regression models (LRMs) predicting the continence rate at 3 and 12 months after RARP were fitted in the overall population. Subsequently, the LRMs were repeated in two subgroup analyses based on prostate size (≤ 40 vs > 40 ml). Overall, 248 consecutive RARP patients were included in the analyses. The rate of continence at 3 and 12 months was 69 and 72%, respectively. After multivariable LRM the bladder neck sparing approach (OR 3.15, 95% CI 1.68–6.09, p value < 0.001) and BMI (OR 0.90, 95% CI 0.82–0.97, p = 0.006) were independent predictors of recovery continence at 3 months. The prostate-gland asymmetry independently predicted lower continence rates at 3 (OR 0.33, 95% CI 0.13–0.83, p = 0.02) and 12 months (OR 0.31, 95% CI 0.10–0.90, p = 0.03) in patients with prostate size ≤ 40 ml. The presence of prostate lobe asymmetry negatively affected the recovery of 3- and 12-months continence in prostate glands ≤ 40 mL. These observations should be considered in the preoperative planning and counseling of RARP patients.

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Complete urethral preservation in robot‐assisted radical prostatectomy: step‐by‐step description of surgical technique

Al‐Hammouri,

Almeida‐Magana,

Tzelves

et al. 2024

BJU International

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Continence-Sparing Techniques in Radical Prostatectomy: A Systematic Review of Randomized Controlled Trials

Cited by 3 publications

References 55 publications

Novel nerve-sparing robot-assisted radical prostatectomy with endopelvic fascia preservation and long-term outcomes for a single surgeon

Novel nerve-sparing robot-assisted radical prostatectomy with endopelvic fascia preservation and long-term outcomes for a single surgeon

The prostate-gland asymmetry affects the 3- and 12-month continence recovery after RARP in patients with small prostate glands: a single center study

Complete urethral preservation in robot‐assisted radical prostatectomy: step‐by‐step description of surgical technique

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