scholarly journals Development and validation of non‐guided bladder‐neck and neurovascular‐bundle dissection modules of the RobotiX‐Mentor® full‐procedure robotic‐assisted radical prostatectomy virtual reality simulation

2020 ◽  
Author(s):  
Jan Ebbing ◽  
Peter N. Wiklund ◽  
Olof Akre ◽  
Stefan Carlsson ◽  
Mats J. Olsson ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Radical Prostatectomy ◽  
Bladder Neck ◽  
Neurovascular Bundle ◽  
Virtual Reality Simulation ◽  
Robotic Assisted ◽  
Robotic Assisted Radical Prostatectomy ◽  
Development And Validation

scholarly journals Perioperative predictors for post-prostatectomy urinary incontinence in prostate cancer patients following robotic-assisted radical prostatectomy: Long-term results of a Canadian prospective cohort

2018 ◽  
Vol 13 (5) ◽  
Author(s):  
Emad Rajih ◽  
Malek Meskawi ◽  
Abdullah M. Alenizi ◽  
Kevin C. Zorn ◽  
Mansour Alnazari ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Urinary Incontinence ◽  
Radical Prostatectomy ◽  
Bladder Neck ◽  
Cox Regression ◽  
Long Term Results ◽  
Cox Regression Analysis ◽  
Robotic Assisted ◽  
Robotic Assisted Radical Prostatectomy ◽  
The Impact

Introduction: We aimed to report the impact of perioperative factors that have not been well-studied on continence recovery following robotic-assisted radical prostatectomy (RARP). Methods: We analyzed data of 322 men with localized prostate cancer who underwent RARP between October 2006 and May 2015 in a single Canadian centre. All patients were assessed at one, three, six, 12, and 24 months after surgery. We evaluated risk factors for post-prostatectomy urinary incontinence from a prospectively collected database in multivariate Cox regression analysis. The primary endpoint was continence, defined as 0 pad usage per day. Results: 0-pad continence rates were 126/322 (39%), 187/321 (58%), 222/312 (71%), 238/294 (80%), and 233/257 (91%) at one, three, six, 12, and 24 months, respectively. Bladder neck preservation (hazard ratio [HR] 0.71; 95% confidence interval [CI] 0.5–0.99; p=0.04), and prostate size (HR 0.99; 95% CI 0.98–0.99; p=0.02) were independent predictors of continence recovery after RARP. Smoking at time of surgery predicted delayed continence recovery on multivariate analysis (HR 1.42; 95% CI 1.01–1.99; p=0.04). Neurovascular bundles preservation was associated with continence recovery after 24 months. No statistically significant correlation was found with other variables, such as age, body mass index, Charlson comorbidity index, preoperative oncological baseline parameters, presence of median lobe, or thermal energy use. Conclusions: Our results confirmed known predictors of postprostatectomy incontinence (PPI), namely bladder neck resection and large prostate volume. Noteworthy, cigarette smoking at the time of RARP was found to be a possible independent risk factor for PPI. This study is hypothesis-generating.

scholarly journals Improvement in early urinary continence recovery after robotic-assisted radical prostatectomy based on postoperative pelvic anatomic features: a retrospective review

BMC Urology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Akihiro Nakane ◽  
Hiroki Kubota ◽  
Yusuke Noda ◽  
Tomoki Takeda ◽  
Yasuhiko Hirose ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Radical Prostatectomy ◽  
Odds Ratio ◽  
Bladder Neck ◽  
Urinary Continence ◽  
Resonance Imaging ◽  
Robotic Assisted ◽  
Neck Width ◽  
Robotic Assisted Radical Prostatectomy

Abstract Background We investigated the impact of postoperative membranous urethral length and other anatomic characteristics of the pelvic floor shape as measured by magnetic resonance imaging on the improvement in continence following robotic-assisted radical prostatectomy. Methods We retrospectively reviewed data from 73 patients who underwent postoperative prostate magnetic resonance imaging following robotic-assisted radical prostatectomy between 2013 and 2018. Patient demographics; pre-, peri-, and post-operative parameters; and pelvic anatomic features on magnetic resonance imaging were reviewed. Patients who used no urinary incontinence pads or pads for protection were considered to have achieved complete continence. Results Urinary continence was restored in 27.4, 53.4, 68.5, and 84.9% of patients at 1, 3, 6, and 12 months after robotic-assisted radical prostatectomy, respectively. When patients were divided into early and late continence groups based on urinary continence at 3 months after robotic-assisted radical prostatectomy, no significantly different clinical characteristics or surgical outcomes were found. However, the mean membranous urethral length (18.5 mm for the early continence group vs. 16.9 mm for the late continence group), levator muscle width (7.1 vs. 6.5 mm, respectively), and bladder neck width on the trigone side (7.2 mm vs. 5.4 mm, respectively) were significantly different between groups (all p < 0.05). Multivariate logistic regression analysis showed that membranous urethral length (odds ratio, 1.227; 95% confidence interval, 1.011–1.489; p = 0.038) and bladder neck width (odds ratio, 1.585; 95% confidence interval, 1.050–2.393; p = 0.028) were associated with the period of early urinary continence. Conclusions Postoperative membranous urethral length and bladder neck width were significantly associated with early urinary continence recovery after robotic-assisted radical prostatectomy. It is highly recommended that surgeons focus on preserving the membranous urethral length and increasing the bladder neck width on the trigone side during surgery to achieve optimal continence outcomes after robotic-assisted radical prostatectomy.

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