Retzius-sparing technique independently predicts early recovery of urinary continence after robot-assisted radical prostatectomy.

Male Humans Middle Aged Infant Robotics Prospective Studies Urinary Incontinence / etiology Robotic Surgical Procedures / methods Treatment Outcome Prostatectomy / adverse effects Prostatic Neoplasms / surgery
Continence Outcomes Prostate cancer Prostatectomy Retzius-sparing

Journal

Journal of robotic surgery
ISSN: 1863-2491
Titre abrégé: J Robot Surg
Pays: England
ID NLM: 101300401

Informations de publication

Date de publication:
Dec 2022
Historique:
received: 13 08 2021
accepted: 06 02 2022
pubmed: 23 2 2022
medline: 29 10 2022
entrez: 22 2 2022
Statut: ppublish

Résumé

Robot-assisted radical prostatectomy (RARP) is the conventional surgical treatment option for localised prostate cancer. We investigated factors which may be associated with recovery of early urinary continence (EUC), including the use of the Retzius-sparing technique (RS-RARP). From March 2018 to December 2018, 501 consecutive patients underwent RARP at our high-volume institution. Four hundred and thirty-one patients had complete follow-up data and were included in our analyses. EUC was defined as zero pad use and social urinary continence (SUC) was defined as ≤ 1 pad/24-h period at 3 months following surgery. Patient demographics and clinical factors such as age, body mass index (BMI), neurovascular bundle (NVB) sparing, RS-RARP operative technique and operating surgeon (consultant, trainee) were recorded. Median age was 64.0 years (IQR 57.0-69.0 years) with a median BMI of 27.0 (IQR 25.0-29.9). RS-RARP accounted for 59 of the 431 (13.7%) patients. 196 (45.5%), 142 (32.9%) and 86 (20.0%) received a bilateral, unilateral and nil NVB sparing, respectively. EUC was achieved by 241 patients (55.9%) and SUC was achieved in 339 (78.7%) patients. Multivariable logistic regression analysis suggests younger age (HR 1.04, 95% CI 1.01-1.07, p = 0.014) and RS-RARP technique (HR 2.19, 95% CI 1.15-4.16, p = 0.017) were independently associated with EUC at 3 months even after adjusting for BMI, external membranous urethral length and NVB sparing. Our results suggest that RS-RARP technique is independently predictive of EUC even after accounting for confounding factors. These findings should be further validated in a prospective or randomised trial.

Identifiants

DOI: 10.1007/s11701-022-01383-z PMID: 35192106
pubmed: 35192106
doi: 10.1007/s11701-022-01383-z
pii: 10.1007/s11701-022-01383-z
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1419-1426

Informations de copyright

© 2022. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.

Références

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Auteurs

Hassan Kadhim (H)

Department of Urology, Ipswich Hospital, Ipswich, UK.

Kar Mun Ang (KM)

Department of Medicine, Queen Elizabeth Hospital, Woolwich, UK.

Wei Shen Tan (WS)

Division of Surgery & Interventional Science, University College London, 3rd floor Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK. wei.tan@ucl.ac.uk.
Department of Urology, University College London Hospital, London, UK. wei.tan@ucl.ac.uk.
Department of Urology, Royal Free Hospital, London, UK. wei.tan@ucl.ac.uk.

Arjun Nathan (A)

Division of Surgery & Interventional Science, University College London, 3rd floor Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK.
Department of Urology, University College London Hospital, London, UK.
Department of Urology, Royal Free Hospital, London, UK.
ORCID: 0000-0002-8572-2832

Nicola Pavan (N)

Department of Urology, University College London Hospital, London, UK.

Giorgio Mazzon (G)

Department of Urology, University College London Hospital, London, UK.

Omar Al-Kadhi (O)

Department of Urology, University College London Hospital, London, UK.

Gu Di (G)

Department of Urology, University College London Hospital, London, UK.

Eoin Dinneen (E)

Division of Surgery & Interventional Science, University College London, 3rd floor Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK.
Department of Urology, University College London Hospital, London, UK.

Tim Briggs (T)

Department of Urology, University College London Hospital, London, UK.

Anand Kelkar (A)

Department of Urology, University College London Hospital, London, UK.

Prabhakar Rajan (P)

Department of Urology, University College London Hospital, London, UK.
Cancer Research UK Barts Centre, Queen Mary University of London, London, UK.

Senthil Nathan (S)

Division of Surgery & Interventional Science, University College London, 3rd floor Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK.
Department of Urology, University College London Hospital, London, UK.

John D Kelly (JD)

Division of Surgery & Interventional Science, University College London, 3rd floor Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK.
Department of Urology, University College London Hospital, London, UK.

Prasanna Sooriakumaran (P)

Division of Surgery & Interventional Science, University College London, 3rd floor Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK.
Department of Urology, University College London Hospital, London, UK.
Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.

Ashwin Sridhar (A)

Division of Surgery & Interventional Science, University College London, 3rd floor Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK.
Department of Urology, University College London Hospital, London, UK.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Retzius-sparing technique independently...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Retzius-sparing technique independently...
questionsmedicales.fr › Personnes › Tranches d'âge › Nourrisson › Retzius-sparing technique independently...
questionsmedicales.fr › Sciences de l'information › Méthodologies informatiques › Algorithmes › Intelligence artificielle › Robotique › Retzius-sparing technique independently...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Retzius-sparing technique independently...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations urologiques › Symptômes de l'appareil urinaire inférieur › Incontinence urinaire › Retzius-sparing technique independently...
questionsmedicales.fr › Technologie, industrie et agriculture › Technologie › Automatisation › Interventions chirurgicales robotisées › Retzius-sparing technique independently...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Retzius-sparing technique independently...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie urogénitale › Procédures de chirurgie urologique › Procédures de chirurgie urologique masculine › Prostatectomie › Retzius-sparing technique independently...
questionsmedicales.fr › Maladies urogénitales › Tumeurs de l'appareil urogénital › Tumeurs de l'appareil génital mâle › Tumeurs de la prostate › Retzius-sparing technique independently...