title: Bladder neck sling suspension during robot-assisted radical prostatectomy to improve early return of urinary continence: a comparative analysis.
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department 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: ykojima@fmu.ac.jp.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kojima
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hamakawa
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Yasue
authors.initials: Y
authors.lastname: Kubota
authors.affiliation: Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan; Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Ogawa
authors.affiliation: Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Haga
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Tozawa
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Shoichi
authors.initials: S
authors.lastname: Sasaki
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Hayashi
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kohri
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D053448:Prostatism / Q000503:physiopathology; D011859:Radiography; D020127:Recovery of Function; D012371:Robotics; D053825:Suburethral Slings; D011795:Surveys and Questionnaires; D013997:Time Factors; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000601:surgery*; D014549:Urinary Incontinence / Q000209:etiology / Q000517:prevention & control*; D014563:Urodynamics