Urinary continence recovery after radical prostatectomy - anatomical/reconstructive and nerve-sparing techniques to improve outcomes.
In an editorial board-moderated debate format, two experts in prostate cancer surgery are challenged with presenting the key strategies in radical prostatectomy that improve urinary functional outcomes. Dr Bernardo Rocco was tasked with arguing the facts that support the anatomical preservation and reconstruction steps that improve urinary continence. Drs Christian Pavlovich and Sasha Druskin were tasked with arguing the facts supporting neurovascular bundle and high anterior release surgical planes that improve urinary continence. Associate Editor John Davis moderates the debate, and outlines the current status of validated patient questionnaires that can be used to evaluate urinary continence, and recent work that allows measuring what constitutes a 'clinically significant' difference that either or both of these surgical techniques could influence. A review of raw data from a publication from Dr Pavlovich's team demonstrates how clinically relevant differences in patient-reported outcomes can be correlated to technique. A visual atlas is presented from both presenting teams, and Dr Davis demonstrates further reproducibility of technique. A linked video on this concept is available as a supplementary file.
Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Christian P
CP
Pavlovich
Ospedale Policlinico e Nuovo Ospedale Civile, S. Agostino Estense, University of Modena and Reggio Emilia, Modena, Italy.
Bernardo
B
Rocco
Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Sasha C
SC
Druskin
MD Anderson Cancer Center, Houston, TX, USA.
John W
0000-0003-3491-7194
JW
Davis
D004210:Dissection; D007172:Erectile Dysfunction / Q000150:complications / Q000209:etiology; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D011467:Prostate / Q000033:anatomy & histology / Q000294:innervation; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D011788:Quality of Life; D020127:Recovery of Function; D014549:Urinary Incontinence / Q000209:etiology*; D014554:Urination
#PCSM; #ProstateCancer; musculofascial plate reconstruction; nerve-sparing prostatectomy; patient-reported outcomes; radical prostatectomy; robot-assisted prostatectomy; urinary continence