Postoperative urinary continence after robot-assisted laparoscopic radical prostatectomy.
OBJECTIVE
Laparoscopic radical prostatectomy has shown excellent results concerning patient morbidity, with less blood loss compared to conventional surgery. Robot-assisted laparoscopy offers several additional important technical improvements and therefore it might be suggested that robotic radical prostatectomy would also offer surgical advantages. The objective of this study was to evaluate urinary continence for the first 72 cases of robot-assisted radical prostatectomy performed by a single surgical team.


METHODS
We analysed the outcomes of the first 72 consecutive patients to undergo robot-assisted prostatectomy for localized prostate cancer at our hospital between January 2002 and May 2004. A self-administered questionnaire concerning urinary status was mailed to the patients 3 and 6 months after surgery. Pre- and peroperative characteristics were obtained from patient medical records. The mean age was 61.2 years (range 36-71 years) and the mean preoperative prostate-specific antigen level was 6.3 ng/ml (range 2.3-10.7 ng/ml). The preoperative clinical stage was T1c, 67%, T2, 28% and T3, 5% and the mean Gleason sum was 6 (range 5-9).


RESULTS
Sixty-one of the 68 patients (90%) reported no use of pads and 6 (9%) used a maximum of 1 pad/day 3-6 months after surgery. One patient reported use of >1 pad/day 6 months after surgery. Three significant complications were noted: ureter injury, haemorrhage and femoral nerve injury.


CONCLUSIONS
In this series, which represents the learning curve for one surgical team, only a tenth of the patients still required pads 3-6 months after surgery. Considering the short follow-up period, the results in this series will probably improve over time.
Carlsson
Stefan
S
Department of Urology, Division of Surgery, Karolinska Hospital, Stockholm, Sweden. stefan.carlsson@kirugi.ki.se
Nilsson
Andreas
A
Wiklund
Peter N
PN
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D004231:Diuresis; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011184:Postoperative Period; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012371:Robotics; D012669:Seminal Vesicles / Q000601:surgery; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery; D014549:Urinary Incontinence / Q000453:epidemiology