Impact of posterior urethral plate repair on continence following robot-assisted laparoscopic radical prostatectomy.
OBJECTIVE
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).


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 30 days, 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.


CONCLUSIONS
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.
Kim
Isaac Yi
IY
Urologic Oncology, The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Hwang
Eun A
EA
Mmeje
Chinedu
C
Ercolani
Matthew
M
Lee
Dong Hyeon
DH
D000368:Aged; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D014521:Urethra / Q000601:surgery*; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000601:surgery