Long-term impact of posterior reconstruction urethrovesical anastomosis during robot-assisted prostatectomy A secondary analysis of a randomized cohort.

IF 2 4区 医学 Q3 UROLOGY & NEPHROLOGY
Braden Millan, Jen Hoogenes, Michael Uy, Raees Cassim, Bobby Shayegan
{"title":"Long-term impact of posterior reconstruction urethrovesical anastomosis during robot-assisted prostatectomy A secondary analysis of a randomized cohort.","authors":"Braden Millan, Jen Hoogenes, Michael Uy, Raees Cassim, Bobby Shayegan","doi":"10.5489/cuaj.9121","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to assess early and late continence rates post-robot-assisted radical prostatectomy (RARP), comparing posterior reconstruction (PR) urethrovesical anastomosis (UVA) to conventional urethrovesical anastomosis (C-UVA).</p><p><strong>Methods: </strong>Consecutive patients with clinically localized prostate cancer undergoing RARP underwent simple randomization to PR-UVA or C-UVA. Return to continence outcomes were assessed using a validated questionnaire (Expanded Prostate Cancer Index Composite [EPIC] Short Form-26) at baseline, two-, three-, four-, six-, eight-, and 12-month followups. Five-year outcomes were assessed by frequency of undergoing continence-improving procedures.</p><p><strong>Results: </strong>A total of 163 patients were randomized 1:1 to PR-UVA or C-UVA from April 2014 to July 2015, and 140 patients completed followup. There were no significant clinical or functional differences between groups preoperatively. Using a continence definition of 0-1 pads/day, the continence rates for PR-UVA vs. C-UVA were 39% vs. 38% at two months, respectively (p=1.0), and 93% vs. 86%, respectively, at 12 months (p=0.3). Frequency of urine leak, quantity of pad use, subjective urinary control, and overall bother improved significantly in all patients during the 12-month study period (p<0.001); however, no difference was demonstrated between groups. Five-year results showed no statistically significant difference in the number of patients undergoing a continence-improving procedure (hazard ratio 1.21, 95% confidence interval 0.40-3.65, p=0.7).</p><p><strong>Conclusions: </strong>PR-UVA failed to show a benefit in short-term return to urinary continence or need for an incontinence-improving procedure five years post-RARP.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"269-274"},"PeriodicalIF":2.0000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12327886/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cuaj-Canadian Urological Association Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5489/cuaj.9121","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: We aimed to assess early and late continence rates post-robot-assisted radical prostatectomy (RARP), comparing posterior reconstruction (PR) urethrovesical anastomosis (UVA) to conventional urethrovesical anastomosis (C-UVA).

Methods: Consecutive patients with clinically localized prostate cancer undergoing RARP underwent simple randomization to PR-UVA or C-UVA. Return to continence outcomes were assessed using a validated questionnaire (Expanded Prostate Cancer Index Composite [EPIC] Short Form-26) at baseline, two-, three-, four-, six-, eight-, and 12-month followups. Five-year outcomes were assessed by frequency of undergoing continence-improving procedures.

Results: A total of 163 patients were randomized 1:1 to PR-UVA or C-UVA from April 2014 to July 2015, and 140 patients completed followup. There were no significant clinical or functional differences between groups preoperatively. Using a continence definition of 0-1 pads/day, the continence rates for PR-UVA vs. C-UVA were 39% vs. 38% at two months, respectively (p=1.0), and 93% vs. 86%, respectively, at 12 months (p=0.3). Frequency of urine leak, quantity of pad use, subjective urinary control, and overall bother improved significantly in all patients during the 12-month study period (p<0.001); however, no difference was demonstrated between groups. Five-year results showed no statistically significant difference in the number of patients undergoing a continence-improving procedure (hazard ratio 1.21, 95% confidence interval 0.40-3.65, p=0.7).

Conclusions: PR-UVA failed to show a benefit in short-term return to urinary continence or need for an incontinence-improving procedure five years post-RARP.

机器人辅助前列腺切除术中后路重建尿道膀胱吻合术的长期影响:一项随机队列的二次分析。
前言:我们旨在评估机器人辅助根治性前列腺切除术(RARP)后的早期和晚期尿失禁率,比较后路重建(PR)尿道膀胱吻合术(UVA)和常规尿道膀胱吻合术(C-UVA)。方法:连续的临床局限性前列腺癌患者接受RARP,简单随机分为PR-UVA或C-UVA。在基线、2个月、3个月、4个月、6个月、8个月和12个月的随访中,使用有效的问卷(扩展前列腺癌指数综合[EPIC]简表26)评估恢复失禁的结果。5年的结果通过进行自控改善手术的频率进行评估。结果:2014年4月至2015年7月共163例患者按1:1随机分为PR-UVA或C-UVA组,140例患者完成随访。术前两组患者临床及功能无明显差异。使用0-1片/天的禁尿定义,2个月时PR-UVA和C-UVA的禁尿率分别为39%和38% (p=1.0), 12个月时分别为93%和86% (p=0.3)。在12个月的研究期间,所有患者的尿漏频率、尿垫使用量、主观尿控制和总体困扰均有显著改善(结论:PR-UVA在rarp后5年内未能显示出短期尿失禁恢复或需要尿失禁改善手术的益处)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Cuaj-Canadian Urological Association Journal
Cuaj-Canadian Urological Association Journal 医学-泌尿学与肾脏学
CiteScore
2.80
自引率
10.50%
发文量
167
审稿时长
>12 weeks
期刊介绍: CUAJ is a a peer-reviewed, open-access journal devoted to promoting the highest standard of urological patient care through the publication of timely, relevant, evidence-based research and advocacy information.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信