title: Simple vs six-branches autologous suburethral sling during robot-assisted radical prostatectomy to improve early urinary continence recovery: prospective randomized study.
abstract: We have recently described the use of a retropubic suburethral autologous sling created and placed during robotic radical prostatectomy (RARP). In this study, we assess the effectiveness of newly designed six-branches compared to two-branches suburethral autologous sling in improving early urinary continence (UC) recovery. 120 patients submitted to RARP were prospectively randomized according to the intraoperative positioning of six-branches (group 1, n = 60) or two-branches autologous sling (group 2, n = 60) obtained by different configuration of a same tract of vas deferens removed. Early UC recovery was assessed at 5 (catheter removal), 10 and 30 days postoperatively through the daily number of pads used and the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF) score. UC was defined as the non-use of pad. Chi square test and Wilcoxon test were used to investigate UC recovery between the two groups. Moreover, post-voiding residual was evaluated in each patient at the same time. At catheter removal, UC rate was in groups 1 and 2, 60 and 35% (p = 0.02); at 10 days 70 and 46% (p = 0.03); at 30 days 87 and 70% (p = 0.04), respectively. One patient in group 1 experienced acute urinary retention at the time of catheter removal and was treated uneventfully with a further 7-day catheterization. These preliminary data indicate that newly designed six-branches suburethral autologous sling is able to increase the rate of early UC recovery compared to the two-arms sling previously described by us.
authors.affiliation: Department of Urology-Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy. a.cestari@auxologico.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Cestari
authors.affiliation: Department of Urology-Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Ferrari
authors.affiliation: Department of Urology-Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy.
authors.forename: Mattia
authors.initials: M
authors.lastname: Sangalli
authors.affiliation: Department of Urology-Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Zanoni
authors.affiliation: Department of Urology-Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Ghezzi
authors.affiliation: Department of Urology-Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Fabbri
authors.affiliation: Department of Urology-Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Sozzi
authors.affiliation: Department of Urology-Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy.
authors.forename: Carolina
authors.initials: C
authors.lastname: Lolli
authors.affiliation: Department of Urology-Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Dell'Acqua
authors.affiliation: Department of Urology-Advanced Urotechnology Center, Scientific Institute "Istituto Auxologico Italiano", Via Mercalli 30, 20122, Milan, Italy.
authors.forename: Patrizio
authors.initials: P
authors.lastname: Rigatti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D065287:Robotic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D053825:Suburethral Slings; D014549:Urinary Incontinence / Q000209:etiology / Q000517:prevention & control*
keywords: Prostate cancer; Retropubic sling; Robotic radical prostatectomy; Urinary incontinence