OBJECTIVE To evaluate associations between baseline characteristics, nerve-sparing (NS) status and return of continence, as a relationship may exist between return to continence and preservation of the neurovascular bundles for potency during radical prostatectomy (RP). PATIENTS AND METHODS The study included 592 consecutive robotic RPs completed between 2002 and 2007. All data were entered prospectively into an electronic database. Continence data (defined as zero pads) was collected using self-administered validated questionnaires. Baseline characteristics (age, International Index of Erectile Function [IIEF-5] score, American Urological Association symptom score, body mass index [BMI], clinical T-stage, Gleason score, and prostate-specific antigen level), NS status and learning curve were retrospectively evaluated for association with overall continence at 1, 3 and 12 months after RP using univariate and multivariable methods. Any patient taking preoperative phosphodiesterase inhibitors was excluded from the postoperative analysis. RESULTS Complete data were available for 537 of 592 patients (91%). Continence rates at 12 months after RP were 89.2%, 88.9% and 84.8% for bilateral NS, unilateral NS and non-NS respectively (P = 0.56). In multivariable analysis age, IIEF-5 score and BMI were significant independent predictors of continence. Cavernosal NS status did not significantly affect continence after adjusting for other co-variables. CONCLUSION After careful multivariable analysis of baseline characteristics age, IIEF-5 score and BMI affected continence in a statistically significant fashion. This suggests that baseline factors and not the physical preservation of the cavernosal nerves predict overall return to continence.

Different grip forces were observed among the various robotic instruments commonly used during urologic surgery and between the Standard and the S and Si platforms.

Robot assisted laparoscopic dismembered pyeloplasty is a feasible technique for ureteropelvic junction reconstruction. When measured by the more stringent application of diuretic renography and analog pain scales, the success rate for ureteropelvic junction obstruction management appears similar to that of open or standard laparoscopic approaches.

Gel and ex vivo isotherms do not predict the in vivo pattern of freezing. Thus, they should not be used for preoperative planning. The cryoprobe should be passed 5 mm beyond the tumor border to achieve suitably cold temperatures. Multipoint thermal sensor probes are recommended to record actual temperature during renal cryotherapy.

The optimal landmark for calculating the placement of ports for the daVinci robotic arm placement should be the pubis and not the umbilicus. Tall men (>72 inches) are at risk for exceeding functional robot arm length, and in these men, port sites should not be more than 18 cm from the pubis.