Article ; Online: Anterior Sphincter-sparing Suturing of the Vesicourethral Anastomosis During Robotic-assisted Laparoscopic Radical Prostatectomy.
2023 Volume 52, Page(s) 109–114
Abstract: Background: Continence is an important functional outcome after robotic-assisted laparoscopic radical prostatectomy (RARP), and modifications of the surgical technique may improve outcomes.: Objective: To illustrate a novel RARP technique and to ... ...
Abstract | Background: Continence is an important functional outcome after robotic-assisted laparoscopic radical prostatectomy (RARP), and modifications of the surgical technique may improve outcomes. Objective: To illustrate a novel RARP technique and to describe the observed continence outcomes. Design setting and participants: A retrospective study of men treated with RARP between 2017 and 2021 was conducted. Surgical procedure: During RARP, periprostatic structures are preserved, the intraprostatic urethra is partially spared, and the anterior anastomosis stitches involve the plexus structures but not the anterior urethra. Measurements: A descriptive analysis of the pathological, functional, and short-term oncological outcomes was performed. Results and limitations: Of 640 men, 448 (70%) with at least 1 yr of follow-up and a median age of 66 yr were included. The median operative time was 270 min and the prostatic volume 52 ml. The transurethral catheter was removed after a median of 3 d, and leakage of urine in the first 24 h after catheter removal was observed in 66/448 patients (15%). Positive surgical margins were reported in 104/448 (23%). Prostate-specific antigen persistence after prostatectomy was observed in 26/448 (6%). During a median follow-up of 2 yr (interquartile range 1-3 yr), the biochemical recurrence after prostatectomy was observed in 19/448 patients (4%). One year after prostatectomy, 406/448 patients (91%) were continent and required no pad at all, while 42/448 (9%) required at least one pad per day. Conclusions: Not stitching the anterior urethra is a novel technical modification and may improve continence outcomes. Patient summary: We describe a novel way to stitch the bladder neck to the urethra after removal of the prostate using a surgical robotic system. Our technique appeared safe, with promising urinary continence results. |
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Language | English |
Publishing date | 2023-05-05 |
Publishing country | Netherlands |
Document type | Journal Article |
ZDB-ID | 3040546-4 |
ISSN | 2666-1683 ; 2058-4881 |
ISSN (online) | 2666-1683 |
ISSN | 2058-4881 |
DOI | 10.1016/j.euros.2023.04.007 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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