scholarly journals Significance of Postoperative Membranous Urethral Length and Position of Vesico-Urethral Anastomosis for Short Term Continence Recovery Following Robot-Assisted Laparoscopic Radical Prostatectomy

2022 ◽  
Author(s):  
Yasukazu Nakanishi ◽  
Shunya Matsumoto ◽  
Naoya Okubo ◽  
Kenji Tanabe ◽  
Madoka Kataoka ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Radical Prostatectomy ◽  
Univariate Analysis ◽  
Operating Time ◽  
Laparoscopic Radical Prostatectomy ◽  
Urinary Continence ◽  
Robot Assisted ◽  
Short Term ◽  
Recovery Rates ◽  
Patient Interview

Abstract Background We assess whether short term recovery of urinary incontinence following robot-assisted laparoscopic radical prostatectomy (RARP) is associated with preoperative membranous urethral length (MUL) and position of vesico-urethral anastomosis (PVUA). Methods Clinical variables including PVUA and pre- and postoperative MUL were evaluated in 251 patients who underwent RARP from August 2019 to February 2021. Continence recovery was defined as no pad or one security liner per day assessed by patient interview at least 6 months follow-up. Univariate and multivariate logistic regression analyses were used to assess variables associated with continence recovery at 3 months after the operation. Results Continence recovery rates at 3 and 6 months were 75% and 84%, respectively. Lower BMI (<25 kg/m2) (p = 0.040), longer preoperative MUL (≥9.5mm) (p = 0.013), longer postoperative MUL (≥9mm) (p <0.001), higher PVUA (<14.5mm) (p = 0.019) and shorter operating time (<170min) (p = 0.013) were significantly associated with continence recovery at 3 months in univariate analysis. Multivariate analysis revealed that postoperative MUL (OR 3.75, 95% CI 1.90 – 7.40, p <0.001) and higher PVUA (OR 2.02, 95% CI 1.07 – 3.82, p = 0.032) were independent factors for continence recovery. Patients were divided into three groups based on the multivariate analysis, with urinary continence recovery rates found to have increased in turn with rates of 43.7% vs. 68.2% vs. 85.0% (p <0.001) at three months. Conclusions PVUA and postoperative MUL were significant factors for short term continence recovery. Preservation of urethral length might contribute to continence recovery after RARP.

scholarly journals Severe intraoperative bleeding predicts the risk of perioperative blood transfusion after robot-assisted radical prostatectomy

2021 ◽  
Author(s):  
Antonio Benito Porcaro ◽  
Riccardo Rizzetto ◽  
Nelia Amigoni ◽  
Alessandro Tafuri ◽  
Aliasger Shakir ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Univariate Analysis ◽  
Operating Time ◽  
Primary Treatment ◽  
Intraoperative Blood Loss ◽  
Robot Assisted ◽  
Intraoperative Bleeding ◽  
Perioperative Blood Transfusion

AbstractTo evaluate potential factors associated with the risk of perioperative blood transfusion (PBT) with implications on length of hospital stay (LOHS) and major post-operative complications in patients who underwent robot-assisted radical prostatectomy (RARP) as a primary treatment for prostate cancer (PCa). In a period ranging from January 2013 to August 2019, 980 consecutive patients who underwent RARP were retrospectively evaluated. Clinical factors such as intraoperative blood loss were evaluated. The association of factors with the risk of PBT was investigated by statistical methods. Overall, PBT was necessary in 39 patients (4%) in whom four were intraoperatively. Positive surgical margins, operating time and intraoperative blood loss were associated with perioperative blood transfusion on univariate analysis. On multivariate analysis, the risk of PBT was predicted by intraoperative blood loss (odds ratio, OR 1.002; 95% CI 1.001–1.002; p < 0.0001), which was associated with prolonged operating time and elevated body mass index (BMI). PBT was associated with delayed LOHS and Clavien–Dindo complications > 2. In patients undergoing RARP as a primary treatment for PCa, the risk of PBT represented a rare event that was predicted by severe intraoperative bleeding, which was associated with increased BMI as well as with prolonged operating time. In patients who received a PBT, prolonged LOHS as well as an elevated risk of major Clavien–Dindo complications were seen.

PE07: Short-term results after robot-assisted laparoscopic radical prostatectomy compared to open surgery

2014 ◽  
Vol 13 (3) ◽  
pp. 18
Author(s):  
A. Wallerstedt ◽  
S. Tyritzis ◽  
T. Thorsteinsdottir ◽  
S. Carlsson ◽  
J. Stranne ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Open Surgery ◽  
Laparoscopic Radical Prostatectomy ◽  
Robot Assisted ◽  
Short Term

Short-term Results after Robot-assisted Laparoscopic Radical Prostatectomy Compared to Open Radical Prostatectomy

2015 ◽  
Vol 67 (4) ◽  
pp. 660-670 ◽  
Author(s):  
Anna Wallerstedt ◽  
Stavros I. Tyritzis ◽  
Thordis Thorsteinsdottir ◽  
Stefan Carlsson ◽  
Johan Stranne ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Laparoscopic Radical Prostatectomy ◽  
Robot Assisted ◽  
Short Term ◽  
Open Radical Prostatectomy

Urinary continence four weeks following Retzius-sparing robotic radical prostatectomy: The UK experience

2017 ◽  
Vol 11 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Christopher G Eden ◽  
Dimitrios Moschonas ◽  
Ricardo Soares
Keyword(s):  
Radical Prostatectomy ◽  
Prostate Specific Antigen ◽  
Clinical Stage ◽  
Operating Time ◽  
Specific Antigen ◽  
Surgical Margin ◽  
Interquartile Range ◽  
Urinary Continence ◽  
Positive Surgical Margin ◽  
Robot Assisted

Objective: The purpose of this study was to investigate urinary continence four weeks following Retzius-sparing robot-assisted radical prostatectomy. Patients and methods: Forty patients with T2–T3 prostate cancer underwent Retzius-sparing-robot-assisted radical prostatectomy and their results were compared with those from the 40 patients having robot-assisted radical prostatectomy done by the same surgeon immediately prior to the adoption of Retzius-sparing-robot-assisted radical prostatectomy. Results: Patients in the two groups had similar age, body mass index, prostate specific antigen, biopsy Gleason sum, clinical stage, d’Amico risk profile, blood loss, prostate weight and post-operative hospital stay. Median operating time (200 (interquartile range=155–266) vs 223 (interquartile range=100–238) min; p=0.05) and catheterisation (8 (interquartile range=8–8) vs 14 (interquartile range=14–14) days; p<0.0001) were shorter in the Retzius-sparing group, many of whom had suprapubic catheters inserted. The overall complication rate was lower in Retzius-sparing patients (2.5% vs 8.0%; p=0.36). Positive surgical margin rates were similar for Retzius-sparing and non-Retzius-sparing patients and decreased with greater experience with the Retzius-sparing technique: 16.7% vs 7.7% for pT2 ( p=0.65) and 31.8% vs 14.3% for pT3 ( p=0.44). Initial prostate specific antigen was <0.1 ng/ml in 97.5% and 100%, respectively ( p=1.00). At four weeks post-operation 0, 1 and 2 pads/day were needed in the Retzius-sparing group in 90.0%, 7.5% and 2.5% of patients, compared to 37.5% ( p<0.0001), 32.5% ( p=0.01) and 30% ( p=0.002) of men having conventional surgery. Conclusion: Retzius-sparing-robot-assisted radical prostatectomy is faster than the anterior approach to the prostate, allows a shorter catheterisation time and produces dramatically better continence results at four weeks with 90% of patients being pad-free and 97.5% of patients needing 0–1 pads/day.

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