Modified apical dissection improves early continence in robot-assisted laparoscopic radical prostatectomy: Comparative study between modified apical dissection and anterior suspension stitch
Investigative and Clinical Urology 2022³â 63±Ç 6È£ p.639 ~ p.646
°ÇÏÀº(Kang Ha-Eun) - Korea University College of Medicine Department of Urology
±è½Âºó(Kim Seung-Bin) - Korea University College of Medicine Department of Urology
³ëÅÂÀÏ(Noh Tae-Il) - Korea University College of Medicine Department of Urology
½ÉÁö¼º(Shim Ji-Sung) - Korea University College of Medicine Department of Urology
°¼®È£(Kang Seok-Ho) - Korea University College of Medicine Department of Urology
ÀüÁØ(Cheon Jun) - Korea University College of Medicine Department of Urology
ÅÂÁ¾Çö(Tae Jong-Hyun) - Chung-Ang University College of Medicine Department of Urology
(Patel Vipul R.) - University of Central Florida College of Medicine Department of Urology
°¼º±¸(Kang Sung-Gu) - Korea University College of Medicine Department of Urology
Abstract
Purpose: Recently, the modified apical dissection (MAD) technique in robot-assisted laparoscopic radical prostatectomy (RARP) has shown excellent functional outcomes but has never been rigorously validated at various institutions. This study aimed to evaluate the effect of MAD on early continence and potency compared with the anterior suspension stitch (SS) technique.
Materials and Methods: A total of 100 patients who underwent RARP with SS and 100 who underwent RARP with MAD by a single surgeon were propensity score matched and retrospectively compared for continence and potency recovery at 1 week and 1, 3, 6, 9, and 12 months.
Results: Continence was reached in 20.6%, 33.3%, 67.2%, 74.1%, 81.1%, and 83.0% of patients in the SS group, compared with 49.2%, 73.3%, 86.8%, 96.6%, 100.0%, and 100.0% in the MAD group at postoperative 1 week and 1, 3, 6, 9, and 12 months, respectively. In the SS group, potency rates were 0.0%, 20.0%, 50.0%, 66.7%, 75.0%, and 83.3%; in the MAD group, the rates were 50.0%, 90.0%, 88.9%, 100.0%, 100.0%, and 100.0%. Recovery of continence was higher in the MAD group within the first 6 months (p=0.005, <0.010, 0.041, 0.016 at 1 week, 1, 3, and 6 months). There were no significant differences in potency recovery rates between the two groups (all p¡Ã0.05).
Conclusions: The MAD technique results in earlier recovery of continence compared with the SS technique.
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Dissection, Neoplasms, Prostatectomy, Robotic surgical procedures, Urinary incontinence
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The MAD technique results in earlier recovery of continence compared with the SS technique.