OBJECTIVE: To present our experience of a novel technique, bladder neck sling suspension technique, in patients undergoing robot-assisted radical prostatectomy (RARP) and evaluate its efficacy for improving early continence outcomes after RARP in comparison with that of the standard technique.
METHODS: Fifty-seven consecutive patients underwent RARP between August 2011 and April 2012. We performed RARP with and without bladder neck sling suspension technique for 27 (sling group) and 30 (nonsling group) patients, respectively, and compared the urinary outcome between the groups. Both subjective and objective assessments of urinary incontinence were performed before and after RARP.
RESULTS: The International Prostate Symptom Score (P <.05) and International Consultation on Incontinence Questionnaire-Short Form (P <.05) in the sling group were significantly lower, and Expanded Prostate Cancer Index Composite urinary incontinence score (P <.05) in the sling group was higher than those in nonsling group, 4 weeks after RARP. In addition, mean pad weight gain on 1-hour pad test in the sling group was significantly smaller than that in the nonsling group, 4 weeks after RARP (P <.05). Both patient perception and objective data of urinary incontinence 4 weeks after RARP were better in the sling group than in the nonsling group. Valsalva maneuver during cystography demonstrated that the mean posterior urethrovesical angle in the sling group was smaller than that in the nonsling group (P <.001).
CONCLUSION: Bladder neck sling suspension technique is a simple and feasible procedure in RARP and can improve the early return of continence after RARP, although additional larger studies are required to confirm this finding.
Written by:
Kojima Y1, Hamakawa T2, Kubota Y2, Ogawa S3, Haga N4, Tozawa K2, Sasaki S2, Hayashi Y2, Kohri K2 Are you the author?
1Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan; Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. Electronic address: . 2Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. 3Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan; Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. 4Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan.
Reference: Urology. 2013 Dec 31 (Epub ahead of print)
doi: 10.1016/j.urology.2013.09.059
PubMed Abstract
PMID: 24387929
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