Effects of New 1-Step Posterior Reconstruction Method on Recovery of Continence after Robot-Assisted Laparoscopic Prostatectomy: Results of a Prospective, Single-Blind, Parallel Group, Randomized, Controlled Trial
2014; Lippincott Williams & Wilkins; Volume: 193; Issue: 3 Linguagem: Inglês
10.1016/j.juro.2014.10.023
ISSN1527-3792
AutoresChang Wook Jeong, Jung Keun Lee, Jong Jin Oh, Sangchul Lee, Seong Jin Jeong, Sung Kyu Hong, Seok‐Soo Byun, Sang Eun Lee,
Tópico(s)Urinary Bladder and Prostate Research
ResumoNo AccessJournal of UrologyAdult Urology1 Mar 2015Effects of New 1-Step Posterior Reconstruction Method on Recovery of Continence after Robot-Assisted Laparoscopic Prostatectomy: Results of a Prospective, Single-Blind, Parallel Group, Randomized, Controlled Trial Chang Wook Jeong, Jung Keun Lee, Jong Jin Oh, Sangchul Lee, Seong Jin Jeong, Sung Kyu Hong, Seok-Soo Byun, and Sang Eun Lee Chang Wook JeongChang Wook Jeong Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea , Jung Keun LeeJung Keun Lee Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea , Jong Jin OhJong Jin Oh Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea , Sangchul LeeSangchul Lee Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea , Seong Jin JeongSeong Jin Jeong Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea , Sung Kyu HongSung Kyu Hong Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea , Seok-Soo ByunSeok-Soo Byun Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea , and Sang Eun LeeSang Eun Lee Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea View All Author Informationhttps://doi.org/10.1016/j.juro.2014.10.023AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We devised a 1-step posterior reconstruction technique that opposes the median dorsal raphe only to the posterior counterpart of the detrusor apron rather than to Denonvilliers' fascia. In a retrospective study we previously found that during robot-assisted laparoscopic prostatectomy this new technique could significantly shorten continence recovery time. We designed a prospective clinical trial to confirm this. Materials and Methods: We designed a single-blind, parallel group, randomized, controlled trial. A total of 100 men who underwent robot-assisted laparoscopic prostatectomy performed by a single surgeon at a referral center were randomly allocated to the intervention group (50) or the control group (50) from October 2012 through August 2013. The intervention group underwent posterior reconstruction with this new technique before vesicourethral anastomosis. All patients in each group were treated with anterior reconstruction. The study primary end point was time to continence recovery, defined as no pad use. Secondary outcomes were time to recovery of social continence, defined as 0 or 1 pad used per day. Results: One control was excluded from analysis due to open conversion and 4 patients were excluded since they withdrew from participation. Median time to complete continence recovery did not differ significantly between the intervention and control groups (106 and 119 days, respectively, p = 0.890). However, time to social continence recovery was significantly shorter in the intervention group than in controls (median 18 vs 30 days, p = 0.024). Conclusions: One-step posterior reconstruction did not significantly shorten time to complete continence recovery. However, it seemed to have a marginal benefit on early recovery of social continence. References 1 : Patient-reported urinary continence and sexual function after anatomic radical prostatectomy. Urology2000; 55: 58. Google Scholar 2 : Restoration of posterior aspect of rhabdosphincter shortens continence time after radical retropubic prostatectomy. J Urol2006; 175: 2201. 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Google Scholar © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byCadeddu J (2017) Re: Advanced Reconstruction of Vesicourethral Support (ARVUS) during Robot-Assisted Radical Prostatectomy: One-Year Functional Outcomes in a Two-Group Randomised Controlled TrialJournal of Urology, VOL. 198, NO. 6, (1191-1191), Online publication date: 1-Dec-2017. Volume 193Issue 3March 2015Page: 935-942Supplementary Materials Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.Keywordsprostatectomyroboticstreatment outcomeprostatic neoplasmsurinary incontinenceAcknowledgmentsProf. So Yeon Ahn, Medical Research Collaboration Center, Seoul National University Bundang Hospital assisted with statistical analysis and random sequence generation. Drs. Hansol Lee, Ki Bum Kim, Ha Rim Kook, and Kwang Mo Kim assisted with the trial.Metrics Author Information Chang Wook Jeong Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea More articles by this author Jung Keun Lee Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea More articles by this author Jong Jin Oh Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea More articles by this author Sangchul Lee Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea More articles by this author Seong Jin Jeong Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea More articles by this author Sung Kyu Hong Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea More articles by this author Seok-Soo Byun Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea More articles by this author Sang Eun Lee Department of Urology, College of Medicine, Seoul National University, Seoul, Republic of Korea Department of Urology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea More articles by this author Expand All Advertisement PDF downloadLoading ...
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