Posterior and anterior fixation of the urethra during robotic prostatectomy improves early continence rates

Koliakos, Nikolaos; Mottrie, Alexandre; Buffi, Nicolò Maria; Naeyer, Geert De; Willemsen, Pieter; Fonteyne, E.

doi:10.3109/00365590903413627

Cited by 47 publications

(27 citation statements)

References 11 publications

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“…In a randomised clinical trial, Jeong et al [23] observed a shorter time to social continence for their one-step posterior reconstruction (18 d) compared to no reconstruction (30 d). In two other randomised clinical trials, Hurtes et al [24] and Koliakos et al [25] found better early continence rates after combined posterior and anterior reconstructions compared to standard single-layer anastomosis. In the largest prospective study to date (803 patients), Coelho et al [26] observed a shorter interval to urinary continence recovery and, similar to our findings, no significant difference in long-term continence rates.…”

Section: Discussionmentioning

confidence: 94%

Advanced Reconstruction of Vesicourethral Support (ARVUS) during Robot-assisted Radical Prostatectomy: One-year Functional Outcomes in a Two-group Randomised Controlled Trial

et al. 2017

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Section: Discussionmentioning

confidence: 94%

Advanced Reconstruction of Vesicourethral Support (ARVUS) during Robot-assisted Radical Prostatectomy: One-year Functional Outcomes in a Two-group Randomised Controlled Trial

et al. 2017

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“…When using a strict 0-pad definition, authors have reported 1 month continence rates varying between 26 and 72%, [14][15][16][17] while other studies reported rates varying between 65% and 85% for a 0-1 safety pad definition. [18][19][20] Comparatively, in our cohort, the continence rate 1 month after RARP was 44% using a strict 0-pad definition, and 63% using a 0-1 safety pad definition.…”

Section: Discussionmentioning

confidence: 96%

Predictors of early continence following robot-assisted radical prostatectomy

Lavigueur-Blouin

Noriega

Valdivieso

et al. 2015

CUAJ

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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.

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“…Buna karşın Koliakos ve Hurtes'in çalışmalarında total rekonstrüksiyon ile daha yüksek kontinans oranları bildirilmiştir (37,39). Tan ve ark.…”

Section: Posterior Ve Anterior Rekonstrüksiyonunclassified

Robot Yardımlı Laparoskopik Radikal Prostatektomide Tam Kontinans İçin Neler Yapılmalı?

Tavukçu¹,

Aytaç²,

Atug³

2015

Endouroloji

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A çık radikal prostatektomi (ARP) sonrası idrar kaçırma, hastaların yaşam kalitesini ve hasta memnuniyetini bozan en önemli etkenlerden biri olarak karşımıza çıkmak-tadır (1). Yıllar boyunca radikal prostatektomi ameliyatlarındaki gelişmelere rağmen ARP ve laparoskopik radikal prostatektomi (LRP) serilerinde %60 ile %95 arasında kontinans oranları bildirilmiştir (2,3,4). Robotik teknolojinin optik büyütme, üç boyutlu görüntü ve 7 derece harekete imkan tanıyan robotik kolları; kontinans ve erektil fonksiyonda etkili anatomik noktaların korunmasına ve perioperatif komplikasyonların azalmasına imkan sağlamaktadır. İlk yıllarda yapılan robot yardımlı laparoskopik radikal prostatektomi (RYLP) operasyonları, açık ve konvansiyonel laparoskopik seriler ile karşılaştırıldığında, kontinans iyileşmesi açısından anlamlı farklılık ve teknikler arasında birbirlerine üstünlük-ler görülmemesine karşın, son yıllarda bildirilen RYLP serilerinde, ameliyat tekniklerindeki gelişmelere paralel olarak kontinans oranlarında oldukça anlamlı iyileşmeler rapor edilmektedir (2). Bu derlememizde RYLP' de tam kontinans elde edilmesi için neler yapılması gerektiğini literatür eşli-ğinde tartışacağız. RYLP Sonrası İdrar Kaçırma Oranları ve İdrar Kaçırmayı Öngören ÖzelliklerGüncel RYLP serilerindeki kontinans durumu Tablo 1'de verilmiştir. Tablo'daki çalışmalarda görüldüğü üzere 12 ay sonunda hiç ped kullanmama temel alındığında kontinans

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Posterior and anterior fixation of the urethra during robotic prostatectomy improves early continence rates

Abstract: The posterior and anterior fixation of the vesicourethral anastomosis during RRP results in an intact sphincteric mechanism, because no stretch is applied to the urethra, resulting in earlier continence.

Cited by 47 publications

References 11 publications

Advanced Reconstruction of Vesicourethral Support (ARVUS) during Robot-assisted Radical Prostatectomy: One-year Functional Outcomes in a Two-group Randomised Controlled Trial

Advanced Reconstruction of Vesicourethral Support (ARVUS) during Robot-assisted Radical Prostatectomy: One-year Functional Outcomes in a Two-group Randomised Controlled Trial

Predictors of early continence following robot-assisted radical prostatectomy

Robot Yardımlı Laparoskopik Radikal Prostatektomide Tam Kontinans İçin Neler Yapılmalı?

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