Effect of Reconstructive Techniques on Continence in Robot-Assisted Laparoscopic Prostatectomy: Novel Combination of Long Urethral Stump and Anterior Suspension Suture.

To investigate the effects of the novel combination of a long urethral stump and anterior suspension suture in patients who underwent Robot-Assisted Laparoscopic Prostatectomy (RALP) for localized prostate cancer.

Of the 40 participating patients, 20 did not undergo any reconstructive technique, whereas the remaining 20 patients underwent reconstructive technique that included the combination of long urethral stump and anterior suspension suture. Body mass index (BMI) (kg/m2), age, preoperative prostate-specific antigen (PSA) levels, prostate volume, Gleason score, D'Amico risk class, clinical stage, operation type and the application of either perioperative or postoperative reconstructive techniques, and the duration of catheterization were the parameters investigated. Continence rate was measured in the 3rd, 6th, and 12th month after the removal of the catheter. Both techniques were compared statistically.

The control and reconstructive groups each comprised 20 patients. Between the groups, no statistically significant differences were observed in age, BMI, American Society of Anesthesiologists class, risk group, prostate weight, perioperative PSA, duration of surgery, duration of hospitalization, surgical margins, and the total amount of bleeding (p>0.05). Continence rate was significantly higher in the reconstructive group in the 3rd and 6th months compared with the control group (p<0.05).

The combination of anterior suspension suture and long urethral stump contributed to early improvement in the continence rates.

The Eurasian journal of medicine. 2020 Feb [Epub]

Ibrahim Karabulut, Fatih Kursat Yilmazel, Ali Haydar Yilmaz, Erkan Cem Celik, Onur Ceylan, Fatih Ozkaya, Senol Adanur, Ozkan Polat

Department of Urology, Health Sciences University Training and Research Hospital, Erzurum, Turkey., Clinic of Urology, Bilecik State Hospital, Bilecik, Turkey., Deparment of Anesthesiolgy and Reanimation, Health Sciences University Training and Research Hospital, Erzurum, Turkey., Deparment of Pathology, Atatürk University, School of Medicine, Erzurum, Turkey., Deparment of Urology, Atatürk University School of Medicine, Erzurum, Turkey.