Impact of Posterior Urethral Plate Repair on Continence Following Robot-Assisted Laparoscopic Radical Prostatectomy
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: The objective of this study is to evaluate the continence rate following reconstruction of the posterior urethral plate in robot-assisted laparoscopic radical prostatectomy (RLRP). Materials and Methods: A retrospective analysis of 50 men with clinically localized prostate cancer who underwent RLRP was carried out. Twenty-five patients underwent RLRP using the reconstruction of the posterior aspect of the rhabdosphincter (Rocco repair). Results of 25 consecutive patients who underwent RLRP prior to the implementation of the Rocco repair were used as the control. Continence was assessed at 7, 30, 90, and 180 days following foley catheter removal using the EPIC questionnaire as well as a follow-up interview with the surgeon. Results: There was no statistically significant difference between the two groups in any of the patient demographics. At 7 days, the Rocco experimental group had a continence rate of 19% vs. 38.1% in the non-Rocco control group (p = 0.306). At 30days, the continence rate in the Rocco group was 76.2% vs. 71.4% in the non-Rocco group (p = 1). At 90 days, the values were 88% vs. 80% (p = 0.718), respectively. At 180 days, the pad-free rate was 96% in both groups. Conclusion: Rocco repair offers no significant advantage in the time to recovery of continence following RLRP when continence is defined as the use of zero pads per day. On the other hand, Rocco repair was associated with increased incidence of urinary retention requiring prolonged foley catheter placement.
Abstract
Purpose: The objective of this study is to evaluate the continence rate following reconstruction of the posterior urethral plate in robot-assisted laparoscopic radical prostatectomy (RLRP). Materials and Methods: A retrospective analysis of 50 men with clinically localized prostate cancer who underwent RLRP was carried out. Twenty-five patients underwent RLRP using the reconstruction of the posterior aspect of the rhabdosphincter (Rocco repair). Results of 25 consecutive patients who underwent RLRP prior to the implementation of the Rocco repair were used as the control. Continence was assessed at 7, 30, 90, and 180 days following foley catheter removal using the EPIC questionnaire as well as a follow-up interview with the surgeon. Results: There was no statistically significant difference between the two groups in any of the patient demographics. At 7 days, the Rocco experimental group had a continence rate of 19% vs. 38.1% in the non-Rocco control group (p = 0.306). At 30days, the continence rate in the Rocco group was 76.2% vs. 71.4% in the non-Rocco group (p = 1). At 90 days, the values were 88% vs. 80% (p = 0.718), respectively. At 180 days, the pad-free rate was 96% in both groups. Conclusion: Rocco repair offers no significant advantage in the time to recovery of continence following RLRP when continence is defined as the use of zero pads per day. On the other hand, Rocco repair was associated with increased incidence of urinary retention requiring prolonged foley catheter placement.
참고문헌 (18)
- Carlson KV, "Prevention and management of incontinence following radical prostatectomy", Urol Clin North Am, 28, pp.595~612 (2001)
- Jacobsen NE, "Open versus laparoscopic radical prostatectomy: a prospective comparison of postoperative urinary incontinence rates", J Urol, 177, pp.615~619 (2007)
- Tewari A, "A prospective comparison of radical retropubic and robot-assisted prostatectomy: experience in one institution", BJU Int, 92, pp.205~210 (2003)
- Hollabaugh RS Jr, "Preservation of putative continence nerves during radical retropubic prostatectomy leads to more rapid return of urinary continence", Urology, 51, pp.960~967 (1998)
- Deliveliotis C, "Radical prostatectomy: bladder neck preservation and puboprostatic ligament sparing--effects on continence and positive margins", Urology, 60, pp.855~858 (2002)
- Poore RE, "Puboprostatic ligament sparing improves urinary continence after radical retropubic prostatectomy", Urology, 51, pp.67~72 (1998)
- Srougi M, "Urinary continence and pathological outcome after bladder neck preservation during radical retropubic prostatectomy: a randomized prospective trial", J Urol, 165, pp.815~818 (2001)
- Rocco F, "Restoration of posterior aspect of rhabdosphincter shortens continence time after radical retropubic prostatectomy", J Urol, 175, pp.2201~2206 (2006)
- Rocco B, "Posterior reconstruction of the rhabdosphincter allows a rapid recovery of continence after transperitoneal videolaparoscopic radical prostatectomy", Eur Urol, 51, pp.996~1003 (2007)
- Hammerer P, "Urodynamic evaluation of changes in urinary control after radical retropubic prostatectomy", J Urol, 157, pp.233~236 (1997)
- Sacco E, "Urinary incontinence after radical prostatectomy: incidence by definition, risk factors and temporal trend in a large series with a long-term follow-up", BJU Int, 97, pp.1234~1241 (2006)
- Bianco FJ Jr, "Variations among high volume surgeons in the rate of complications after radical prostatectomy: further evidence that technique matters", J Urol, 173, pp.2099~2103 (2005)
- Nguyen MM, "Early continence outcomes of posterior musculofascial plate reconstruction during robotic and laparoscopic prostatectomy", BJU Int, 101, pp.1135~1139 (2008)
- Walsh PC, "Patient-reported urinary continence and sexual function after anatomic radical prostatectomy", Urology, 55, pp.58~61 (2000)
- Anastasiadis AG, "Radical retropubic versus laparoscopic prostatectomy:a prospective comparison of functional outcome", Urology, 62, pp.292~297 (2003)
- Lepor H, "The impact of open radical retropubic prostatectomy on continence and lower urinary tract symptoms: a prospective assessment using validated self-administered outcome instruments", J Urol, 171, pp.1216~1219 (2004)
- Guillonneau B, "Laparoscopic radical prostatectomy: assessment after 550 procedures", Crit Rev Oncol Hematol, 43, pp.123~133 (2002)
- Abbou CC, "Laparoscopic radical prostatectomy: preliminary results", Urology, 55, pp.630~634 (2000)
