Purpose: Continence is one of the major outcomes following robot-assisted laparoscopic radical prostatectomy (RARP). Post-operative incontinence influenced mental status and quality of life in patients underwent RARP. In this study, we investigate whether the peri-urethral reconstruction (PUR) influence continence outcome after RARP.

Materials and Methods: From June 2014 to March 2016, 34 patients underwent RARP in our institution. PUR was performed randomly. The anterior reconstruction consisted a suspension of the dorsal venous plexus and anterior urethra to the pubic symphysis. The posterior reconstruction consisted of a repair of the Denonvilliers fascia and an approximation of the posterior bladder neck to the posterior urethra. Demographics, perioperative parameters and continence outcome were collected prospectively. The achievement of continence was defined as less than 1 pad a day.

Results: Twenty-three patients under went RARP with PUR while other eleven patients were not. The median age of the 2 groups were 68 (42–75) and 73 (52–79) years old. The median operative time of two groups were 280 and 365 minutes, and the hospital stay of the two groups were 10 days and 11.5 days.The overall complication rate was 20.6%. The immediate continence rates between patients with and without PUR were 43.5%and38.2%. The early continence rates (< 3 months) between patients with and without PUR were 78.3% and64.7%. Significant quicker recovery of the patients underwent RARP plus PUR was found. (p<0.05) The post-operative stage and PSA level were not associated with continence outcome.

Conclusion: RARP plus PUR offered a better continence recovery. No significant increase of operative time and hospital stay can be noted.

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Published on 04/10/16

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