title: Novel posterior reconstruction technique during robot-assisted laparoscopic prostatectomy: description and comparative outcomes.
abstract: The aim of the present study was to assess the impact of a novel posterior reconstruction technique during robot-assisted laparoscopic prostatectomy on continence recovery. A total of 116 consecutive patients who received the novel posterior reconstruction (case group) were retrospectively compared with a cohort of 126 patients who did not receive posterior reconstruction (control group). The primary end-point was the duration of continence recovery (no pad use) after robot-assisted laparoscopic prostatectomy. The posterior reconstruction was obtained by opposing the median dorsal fibrous raphe to the posterior counterpart of the detrusor apron, rather than the Denonvilliers' fascia. The case group showed higher continence rates at all points of evaluation, which were 2 weeks (30.1% vs 19.8%), 1 month (58.4% vs 45.7%), 3 months (82.7% vs 70.5%) and 6 months postoperatively (95.3% vs 86.4%) (P = 0.007). Application of the novel posterior reconstruction technique, age and length of membranous urethra were significant variables for the complete recovery of continence on multivariable analysis. This study shows that the application of this novel PR technique significantly improves the recovery of continence in patients undergoing robot-assisted laparoscopic prostatectomy.
authors.affiliation: Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Chang Wook
authors.initials: CW
authors.lastname: Jeong
authors.forename: Jong Jin
authors.initials: JJ
authors.lastname: Oh
authors.forename: Seong Jin
authors.initials: SJ
authors.lastname: Jeong
authors.forename: Sung Kyu
authors.initials: SK
authors.lastname: Hong
authors.forename: Seok-Soo
authors.initials: SS
authors.lastname: Byun
authors.forename: Gheeyoung
authors.initials: G
authors.lastname: Choe
authors.forename: Sang Eun
authors.initials: SE
authors.lastname: Lee
mesh_terms: D000367:Age Factors; D000368:Aged; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D012371:Robotics; D013997:Time Factors; D016896:Treatment Outcome; D014521:Urethra / Q000033:anatomy & histology / Q000502:physiology*; D001743:Urinary Bladder / Q000502:physiology*; D014549:Urinary Incontinence / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control