Yu-Hsiang Huang, Jonathan Y J Chen, See-Tong Pang, Kai-Jie Yu, Hung-Cheng Kan, I-Hung Shao, Liang-Kang Huang, Chun-Te Wu, Po-Hung Lin
{"title":"Cystopexy following anterior-approach robot-assisted radical prostatectomy enhances early continence recovery.","authors":"Yu-Hsiang Huang, Jonathan Y J Chen, See-Tong Pang, Kai-Jie Yu, Hung-Cheng Kan, I-Hung Shao, Liang-Kang Huang, Chun-Te Wu, Po-Hung Lin","doi":"10.1007/s11701-025-02253-0","DOIUrl":null,"url":null,"abstract":"<p><p>To evaluate the effect of cystopexy on continence recovery after anterior-approach transperitoneal robot-assisted radical prostatectomy (RaRP). We retrospectively analyzed continence recovery of patients with prostate cancer receiving RaRP in a transperitoneal anterior-approach manner with or without cystopexy. Continence recovery is defined as complete intact continence without safety pad utility. Demographic data, preoperative cancer staging, intraoperative surgical techniques such as neurovascular bundle (NVB) preservation, bladder neck sparing (BNS), cystopexy and postoperative cancer stage, surgical margin status were analyzed via multivariable and univariable regression analysis to evaluate contributing factors associated with continence recovery. We included one hundred and sixty-one consecutive RaRP performed by a single surgeon from 2011 to 2019 without cystopexy and another forty-one consecutive RaRP performed by another single surgeon with cystopexy from 2019 to 2023. Compared to patients without cystopexy, patients receiving cystopexy after anterior-approach RaRP have significant early continence recovery rate at 1-week (p < 0.0001) and 4-weeks (p = 0.0391). In addition, multivariable regression analysis revealed that BNS contributed to better continence recovery at 4 weeks (p = 0.0094). Patients receiving RaRP without NVB preservation had worse continence recovery at 12 weeks (p = 0.0015) and 24 weeks (p = 0.0098). Cystopexy after anterior -approach RaRP may enhance early recovery of continence at 1 week and 4 weeks. The simple technique may be adapted for a better functional outcome of continence.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"114"},"PeriodicalIF":2.2000,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Robotic Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11701-025-02253-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
To evaluate the effect of cystopexy on continence recovery after anterior-approach transperitoneal robot-assisted radical prostatectomy (RaRP). We retrospectively analyzed continence recovery of patients with prostate cancer receiving RaRP in a transperitoneal anterior-approach manner with or without cystopexy. Continence recovery is defined as complete intact continence without safety pad utility. Demographic data, preoperative cancer staging, intraoperative surgical techniques such as neurovascular bundle (NVB) preservation, bladder neck sparing (BNS), cystopexy and postoperative cancer stage, surgical margin status were analyzed via multivariable and univariable regression analysis to evaluate contributing factors associated with continence recovery. We included one hundred and sixty-one consecutive RaRP performed by a single surgeon from 2011 to 2019 without cystopexy and another forty-one consecutive RaRP performed by another single surgeon with cystopexy from 2019 to 2023. Compared to patients without cystopexy, patients receiving cystopexy after anterior-approach RaRP have significant early continence recovery rate at 1-week (p < 0.0001) and 4-weeks (p = 0.0391). In addition, multivariable regression analysis revealed that BNS contributed to better continence recovery at 4 weeks (p = 0.0094). Patients receiving RaRP without NVB preservation had worse continence recovery at 12 weeks (p = 0.0015) and 24 weeks (p = 0.0098). Cystopexy after anterior -approach RaRP may enhance early recovery of continence at 1 week and 4 weeks. The simple technique may be adapted for a better functional outcome of continence.
期刊介绍:
The aim of the Journal of Robotic Surgery is to become the leading worldwide journal for publication of articles related to robotic surgery, encompassing surgical simulation and integrated imaging techniques. The journal provides a centralized, focused resource for physicians wishing to publish their experience or those wishing to avail themselves of the most up-to-date findings.The journal reports on advance in a wide range of surgical specialties including adult and pediatric urology, general surgery, cardiac surgery, gynecology, ENT, orthopedics and neurosurgery.The use of robotics in surgery is broad-based and will undoubtedly expand over the next decade as new technical innovations and techniques increase the applicability of its use. The journal intends to capture this trend as it develops.