E-ISSN: 3061-9947
How does posterior rhabdosfinter reconstruction affect the results of robotic radical prostatectomy?
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Original Article
VOLUME: 52 ISSUE: 3
P: 410 - 415
2019

How does posterior rhabdosfinter reconstruction affect the results of robotic radical prostatectomy?

Acta Haematol Oncol Turc 2019;52(3):410-415
Murat Keske 1
Erem Asil 2
Bahri Gok 3
Nurullah Hamidi 4
Abdullah Erdem Canda 5
Ali Fuat Atmaca 3
1. Kayseri City Hospital, Department Of Urology, Kayseri, Turkey
2. Ankara Atatürk Training And Research Hospital, Department Of Urology, Ankara, Turkey
3. Yildirim Beyazit University, School Of Medicine Affiliated With Ankara Ataturk Training And Research Hospital, Department Of Urology, Ankara, Turkey
4. University Of Health Sciences, School Of Medicine, Dr. Abdurrahman Yurdaslan Oncology Training And Research Hospital, Department Of Urology, Ankara, Turkey
5. Koc University, School Of Medicine, Department Of Urology, Istanbul, Turkey
6.
No information available.
No information available
Received Date: 2019-03-23T20:26:48
Accepted Date: 2019-12-27T14:25:01
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Abstract

INTRODUCTION

There are studies investigating the effect of posterior rhabdosfinkter reconstruction on urinary continent before uretrovesical anastomosis. In this study, we investigated the effect of posterior rhabdosfinkter reconstruction on the results of robotic radical prostatectomy in a high-volume robotic surgery center.

METHODS

Procedures were included by 3 surgeons surgeon (AFA,AEC,EA) after having an experience of >50 cases.Group-1: posterior rhabdosfincter reconstruction suture was performed, n=133.Group-2: posterior rhabdosfincter reconstruction suture was not performed, n=439. Mean patient age and preoperative serum PSA were 63.6±6.5 vs 63.1±6.9 years (p=0.505); 10.9±8.7 vs 10.1±8.7 ng/ml in Groups 1 and 2, respectively (p=0.454).Bilateral neurovascular bundle (NVB) sparing, unilateral NVB-sparing and non-NVB sparing were performed in 97 (72.9%), 20 (15%) and 16 (12%) Group-1 and 311 (70.8%), 72 (16.4%) and 56 (12.7%) in Group-2 patients, respectively.

RESULTS

Mean prostate weights were 65.7±31.7 gr and 62.2±30.7 gr in Groups 1 and 2, respectively (p=0.259).Mean console time, intraoperative blood loss, duration of hospital stay and urethral catheter removal time in Groups 1 and 2 were 143.8±37.4 vs 143.1±37.6 min (p=0.886); 93.4±68.3 vs 101.2±72.1 cc (p=0.277); 3.8±1.7 vs 4.2±2.1 days (p=0.027) and 8.6±2.9 vs 8.9±3.7 days (p=0.447), respectively.Full continence was defined as no pad usage (0 pad/day). Of the available 103 and 322 patients, following removal of the catheter, immediate continence rate was 68.9% and 55.9% in Groups 1 and 2, respectively (p=0.019).On postop 1st-month, 78.6% and 72.6% of the patients in Groups 1 and 2, respectively were fully continent (p=0.230).On postop 3rd-month, 90.2% and 87.5% of the patients in Groups 1 and 2, respectively were fully continent (p=0.412).On postop 6th-month, 95.1% and 94.4% of the patients in Groups 1 and 2, respectively were fully continent (p=0.612).

DISCUSSION AND CONCLUSION

We conclude that, due to our experience RARP procedure with posterior rhabdosphincter reconstruction has an advantage in terms of gaining postoperative early urinary continence.

Keywords:
Robotic prostatectomy, prostate cancer, posterior reconstruction
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