title: Current techniques to improve outcomes for early return of urinary continence following robot-assisted radical prostatectomy.
abstract: Although open retropubic radical prostatectomy has been the most commonly used surgical technique for patients with localized prostate cancer for decades, robot-assisted radical prostatectomy (RARP) has recently become an alternative option and widely used in Japan as well as around the world. RARP has been shown to have higher postoperative continent rates than retropubic and laparoscopic radical prostatectomy; however, urinary incontinence has remained one of the most significant causes for concern among patients who seek surgical treatment for prostate cancer, even after the introduction of RARP. The literature has shown that certain technical modifications to improve urinary continence are advocated as potential aids to reduce the risk of urinary incontinence after RARP. These modifications might be divided into 3 categories to realize the improvement of early return of urinary continence after RARP: 1) preservation, 2) reconstruction, and 3) reinforcement of the anatomic structures in the pelvis, which will make a new supporting system after radical prostatectomy. In this review, we discuss the intraoperative techniques to improve outcomes for early return of urinary continence following RARP, and provide a critical summary of current knowledge on its outcome in the literature.
authors.affiliation: Department of Urology, Fukushima Medical University School of Medicine.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Yanagida
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Koguchi
authors.forename: Junya
authors.initials: J
authors.lastname: Hata
authors.forename: Michihiro
authors.initials: M
authors.lastname: Yabe
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Sato
authors.forename: Hidenori
authors.initials: H
authors.lastname: Akaihata
authors.forename: Yohei
authors.initials: Y
authors.lastname: Kawashima
authors.forename: Masao
authors.initials: M
authors.lastname: Kataoka
authors.forename: Soichiro
authors.initials: S
authors.lastname: Ogawa
authors.forename: Shin
authors.initials: S
authors.lastname: Kumagai
authors.forename: Ken
authors.initials: K
authors.lastname: Kumagai
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Haga
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Kushida
authors.forename: Kei
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Ken
authors.initials: K
authors.lastname: Aikawa
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kojima
mesh_terms: D006801:Humans; D007564:Japan; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery; D020127:Recovery of Function; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D014549:Urinary Incontinence / Q000209:etiology / Q000517:prevention & control; D014553:Urinary Tract Physiological Phenomena