Current Techniques to Improve Outcomes for Early Return of Urinary Continence Following Robot-Assisted Radical Prostatectomy

Abstract

: Although open retropubic radical prostatectomy has been the most commonly used surgical technique for patients with localized prostate cancer for decades, robot -assisted radical prostatectomy (RARP) has recently become an alternative option and widely used in Japan as well as around the world. RARP has been shown to have higher postoperative continent rates than retropubic and laparoscopic radical prostatectomy ; however, urinary incontinence has remained one of the most significant causes for concern among patients who seek surgical treatment for prostate cancer, even after the introduction of RARP. The literature has shown that certain technical modifications to improve urinary continence are advocated as potential aids to reduce the risk of urinary incontinence after RARP. These modifications might be divided into 3 categories to realize the improvement of early return of urinary continence after RARP : 1) preservation, 2) reconstruction, and 3) reinforcement of the anatomic structures in the pelvis, which will make a new supporting system after radical prostatectomy. In this review, we discuss the intraoperative techniques to improve outcomes for early return of urinary continence following RARP, and provide a critical summary of current knowledge on its outcome in the literature.

Total anatomical reconstruction during robot‐assisted radical prostatectomy: focus on urinary continence recovery and related complications after 1000 procedures

“…The impact of UI after RP on patient's QoL has driven the development of more refined surgical techniques . It is well known that the preservation of a normal pelvic anatomy is of utmost importance to maintain good postoperative urinary continence , together with the application of some reconstructive techniques which could influence early postoperative continence recovery .…”

A comparison of the dose from natural radionuclides and artificial radionuclides after the Fukushima nuclear accident

“…A program by Fukushima Prefecture authorities estimated the internal dose due to intake of radiocesium using WBC measurements for more than 150 000 residents (as of September 2013), and most of the estimated doses (99.98%) were <1 mSv in terms of the committed effective dose [ 57 ]. Tsubokura et al .…”

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