title: Randomized clinical trial of a bladder neck plication stitch during robot-assisted radical prostatectomy.
abstract: Urinary incontinence after robot-assisted radical prostatectomy (RARP) is one of the most bothersome complications affecting patients' daily lives. The efficacy of the bladder neck plication stitch technique in promoting an earlier return of continence was prospectively evaluated in 158 patients who underwent RARP for clinically localized prostate cancer by a single surgeon at our institute from March 2012 to January 2013. Patients were randomized 1:1 to undergo surgery with (n = 79) or without (n = 79) the bladder neck plication stitch, and their time to recovery from incontinence, defined as being pad free, was compared. Recovery from incontinence at 1, 3, and 6 months were observed in 22 (27.8%), 42 (53.2%), and 57 (72.2%) patients, respectively, treated with, and 23 (29.1%), 47 (59.5%), and 59 (74.7%) patients, respectively, treated without the bladder neck plication stitch, with no significant difference in time to recovery from incontinence between the two groups. Multivariate analysis showed that age, membranous urethral length and shape of the prostatic apex on magnetic resonance imaging were independent predictors of early recovery from urinary incontinence after RARP. The bladder neck plication stitch had no effect on time to recovery from postoperative urinary incontinence following RARP.
authors.forename: Seung-Kwon
authors.initials: SK
authors.lastname: Choi
authors.forename: Sejun
authors.initials: S
authors.lastname: Park
authors.affiliation: Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Hanjong
authors.initials: H
authors.lastname: Ahn
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D011446:Prospective Studies; D011467:Prostate / Q000601:surgery; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000601:surgery*; D020127:Recovery of Function; D065287:Robotic Surgical Procedures / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology* / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male