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Tips to Preserve Continence During Robotic Radical Prostatectomy

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Practical Tips in Urology

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Abstract

While incontinence and impotence are the two major drawbacks of radical prostatectomy, incontinence seems to be the problem that troubles patients most, even if it occurs less frequently than impotence. The prevalence of urinary incontinence after radical prostatectomy can be influenced by preoperative patient characteristics, surgeon experience, surgical techniques and methods used to collect and report data. In this chapter we will focus on surgical tips to improve continence recovery during robot assisted radical prostatectomy (RARP), analyzing the procedures step by step.

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References

  1. Guideline for the management of clinically localized prostate cancer (2007). Reviewed and validity confirmed 2011. Available from: https://www.auanet.org/common/pdf/education/clinical-guidance/Prostate-Cancer.pdf.

  2. Ficarra V, Novara G, Rosen RC, Artibani W, Carroll PR, Costello A, et al. Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. Eur Urol. 2012;62(3):405–17.

    Article  PubMed  Google Scholar 

  3. von Bodman C, Matsushita K, Savage C, Matikainen MP, Eastham JA, Scardino PT, et al. Recovery of urinary function after radical prostatectomy: predictors of urinary function on preoperative prostate magnetic resonance imaging. J Urol. 2012;187:945–50.

    Article  Google Scholar 

  4. Hakimi AA, Faleck DM, Agalliu I, Rozenblit AM, Chernyak V, Ghavamian R, et al. Preoperative and intraoperative measurements of urethral length as predictors of continence after robot-assisted radical prostatectomy. J Endourol. 2011;25:1025–30.

    Google Scholar 

  5. Patel VR, Coelho RF, Palmer KJ, Rocco B. Periurethral suspension stitch during robot-assisted laparoscopic radical prostatectomy: description of the technique and continence outcomes. Eur Urol. 2009;56:472–8.

    Article  PubMed  Google Scholar 

  6. Lei Y, Alemozaffar M, Williams SB, Hevelone N, Lipsitz SR, Plaster BA, et al. Athermal division and selective suture ligation of the dorsal vein complex during robot-assisted laparoscopic radical prostatectomy: description of technique and outcomes. Eur Urol. 2011;59:235–43.

    Article  PubMed  Google Scholar 

  7. Kojima Y, Takahashi N, Haga N, Nomiya M, Yanagida T, Ishibashi K, et al. Urinary incontinence after robot-assisted radical prostatectomy: pathophysiology and intraoperative techniques to improve surgical outcome. Int J Urol. 2013;20(11):1052–63.

    Article  PubMed  Google Scholar 

  8. Licht MR, Klein EA, Tuason L, Levin H. Impact of bladder neck preservation during radical prostatectomy on continence and cancer control. Urology. 1994;44:883–7.

    Article  CAS  PubMed  Google Scholar 

  9. Katz R, Salomon L, Hoznek A, de la Taille A, Antiphon P, Abbou CC. Positive surgical margins in laparoscopic radical prostatectomy: the impact of apical dissection, bladder neck remodeling and nerve preservation. J Urol. 2003;169:2049–52.

    Article  PubMed  Google Scholar 

  10. Nyarangi-Dix JN, Radtke JP, Hadaschik B, Pahernik S, Hohenfellner M. Impact of complete bladder neck preservation on urinary continence, quality of life and surgical margins after radical prostatectomy: a randomized, controlled, single blind trial. J Urol. 2013;189(3):891–8.

    Article  PubMed  Google Scholar 

  11. Lee Z, Sehgal SS, Graves RV, Su YK, Llukani E, Monahan K, et al. Functional and oncologic outcomes of graded bladder neck preservation during robot-assisted radical prostatectomy. J Endourol. 2014;28(1):48–55.

    Article  PubMed  Google Scholar 

  12. Lee DI, Wedmid A, Mendoza P, Sharma S, Walicki M, Hastings R, et al. Bladder neck plication stitch: a novel technique during robot-assisted radical prostatectomy to improve recovery of urinary continence. J Endourol. 2011;25:1873–7.

    Article  PubMed  Google Scholar 

  13. Lin VC, Coughlin G, Savamedi S, Palmer KJ, Coelho RF, Patel VR, et al. Modified transverse plication for bladder neck reconstruction during robotic-assisted laparoscopic prostatectomy. BJU Int. 2009;104:878–81.

    Article  PubMed  Google Scholar 

  14. Vora AA, Dajani D, Lynch JH, Kowalczyk KJ. Anatomic and technical considerations for optimizing recovery of urinary function during robotic-assisted radical prostatectomy. Curr Opin Urol. 2013;23(1):78–87.

    Article  PubMed  Google Scholar 

  15. Choi WW, Freire MP, Soukup JR, Yin L, Lipsitz SR, Carvas F, et al. Nerve-sparing technique and urinary control after robot-assisted laparoscopic prostatectomy. World J Urol. 2011;29(1):21–7.

    Article  PubMed  Google Scholar 

  16. Kowalczyk KJ, Huang AC, Hevelone ND, Lipsitz SR, Yu HY, Lynch JH, et al. Effect of minimizing tension during robotic-assisted laparoscopic radical prostatectomy on urinary function recovery. World J Urol. 2013;31(3):515–21.

    Article  PubMed  Google Scholar 

  17. Suardi N, Moschini M, Gallina A, Gandaglia G, Abdollah F, Capitanio U, et al. Nerve-sparing approach during radical prostatectomy is strongly associated with the rate of postoperative urinary continence recovery. BJU Int. 2013;111(5):717–22.

    Article  CAS  PubMed  Google Scholar 

  18. Stolzenburg JU, Kallidonis P, Do M, Dietel A, Häfner T, Rabenalt R, et al. A comparison of outcomes for interfascial and intrafascial nerve-sparing radical prostatectomy. Urology. 2010;76(3):743–8.

    Article  PubMed  Google Scholar 

  19. Stolzenburg JU, Rabenalt R, Do M, Horn LC, Liatsikos EN. Modular training for residents with no prior experience with open pelvic surgery in endoscopic extraperitoneal radical prostatectomy. Eur Urol. 2006;49:491–8; discussion 9–500.

    Article  PubMed  Google Scholar 

  20. Myers RP, Cahill DR, Devine RM, King BF. Anatomy of radical prostatectomy as defined by magnetic resonance imaging. J Urol. 1998;159:2148–58.

    Article  CAS  PubMed  Google Scholar 

  21. Tewari AK, Srivastava A, Mudaliar K, Tan GY, Grover S, El Douaihy Y, et al. Anatomical retro-apical technique of synchronous (posterior and anterior) urethral transaction: a novel approach for ameliorating apical margin positivity during robotic radical prostatectomy. BJU Int. 2010;106:1364–73.

    Google Scholar 

  22. Rocco F, Carmignani L, Acquati P, Gadda F, Dell’Orto P, Rocco B, et al. Restoration of posterior aspect of rhabdosphincter shortens continence time after radical retropubic prostatectomy. J Urol. 2006;175(6):2201–6.

    Article  CAS  PubMed  Google Scholar 

  23. Coughlin G, Dangle PP, Patil NN, Palmer KJ, Woolard J, Jensen C, et al. Surgery illustrated – focus on details. Modified posterior reconstruction of the rhabdosphincter: application to robotic-assisted laparoscopic prostatectomy. BJU Int. 2008;102(10):1482–5.

    Google Scholar 

  24. Coelho RF, Chauhan S, Orvieto MA, Sivaraman A, Palmer KJ, Coughlin G, et al. Influence of modified posterior reconstruction of the rhabdosphincter on early recovery of continence and anastomotic leakage rates after robot-assisted radical prostatectomy. Eur Urol. 2011;59(1):72–80.

    Article  PubMed  Google Scholar 

  25. Rocco B, Cozzi G, Spinelli MG, Coelho RF, Patel VR, Tewari A, et al. Posterior musculofascial reconstruction after radical prostatectomy: a systematic review of the literature. Eur Urol. 2012;62(5):779–90.

    Article  PubMed  Google Scholar 

  26. Van Velthoven RF, Ahlering TE, Peltier A, Skarecky DW, Clayman RV. Technique for laparoscopic running urethrovesical anastomosis: the single knot method. Urology. 2003;61(4):699–702.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Clinica Urologica I, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, Milan, Italy

    Bernardo Rocco MD, Elisa De Lorenzis MD & Angelica Anna Chiara Grasso MD

Authors
  1. Bernardo Rocco MD
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  2. Elisa De Lorenzis MD
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  3. Angelica Anna Chiara Grasso MD
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Corresponding author

Correspondence to Bernardo Rocco MD .

Editor information

Editors and Affiliations

  1. Department of Urology, East Surrey Hospital, Redhill, United Kingdom

    Abhay Rané

  2. Department of Urology, Ege University School of Medicine, İzmir, Turkey

    Burak Turna

  3. Case Western University, University Hospitals Urology Institute, Cleveland, Ohio, USA

    Riccardo Autorino

  4. Urology, SLK Kliniken, Heilbronn, Baden-Württemberg, Germany

    Jens J. Rassweiler

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© 2017 Springer-Verlag London

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Rocco, B., De Lorenzis, E., Grasso, A.A.C. (2017). Tips to Preserve Continence During Robotic Radical Prostatectomy. In: Rané, A., Turna, B., Autorino, R., Rassweiler, J. (eds) Practical Tips in Urology. Springer, London. https://doi.org/10.1007/978-1-4471-4348-2_65

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  • DOI: https://doi.org/10.1007/978-1-4471-4348-2_65

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4347-5

  • Online ISBN: 978-1-4471-4348-2

  • eBook Packages: MedicineMedicine (R0)

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