Re: Is It Just Enough to Keep Long Membranous Urethra for Providing Early Continence After Robot-Assisted Laparoscopic Radical Prostatectomy?

Akın, Yiğit; Tunç, Lütfi

doi:10.1089/end.2015.0470

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…The continence results and the feasibility of the SSA need further study among larger numbers of patients and validation among a wider urologic community. The ideal technique should probably include the best quality of dissection to preserve the anatomic structures, 30 the reconstruction of the surrounding fascial structures, and also the preservation of the sphincter during the suture as described above.…”

Section: Discussionmentioning

confidence: 99%

Subsphincteric Anastomosis During Laparoscopic Robot-Assisted Radical Prostatectomy and Its Positive Impact on Continence Recovery

Alméras¹,

Tollon²,

Salin³

et al. 2020

Journal of Endourology

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Introduction: To assess the interest of a new sphincter preserving anastomosis technique for continence recovery after robot-assisted laparoscopic radical prostatectomy (RALP). Materials and Methods: We performed a monocentric single-operator study on 187 consecutive RALP. Patients were divided into two groups: Group 1 (standard anastomosis, until December 2017) and Group 2 (subsphincteric anastomosis [SSA], since January 2018). The SSA consisted in respecting the sphincteric sleeve during the anastomosis suturing only the internal layer of the urethra with the bladder and thereby avoiding the loss of sphincteric length induced by the suture. Pre-, intra-, and postoperative data were prospectively collected and compared. Criteria of continence were as follows: no pad use and complete absence of leakage at catheter removal at 1 month and 1 year. Results: The two groups were comparable in terms of prostate-specific antigen, gland volume, and Gleason score. In Group 2 (SSA), we observed a complete continence recovery in 75.6% at catheter removal (p = 0.0000035), in 82.9% at 1 month (p = 0.000092), and in 97.5% at 1 year (p = 0.028), independently of bladder neck preservation (p = 0.388). There was also a significant difference between the two groups concerning urinary reeducation requirement (p = 0.0006), pad use, and urinary quality of life (p = 0.0000002). No anastomosis complication was reported. Conclusions: The SSA significantly improved the rates of immediate, early, and 1-year continence recovery after RALP. These results need further study among larger numbers of patients.

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Section: Discussionmentioning

confidence: 99%