Abstract:Abstract. The aim of this study was to evaluate the efficacy of our modified posterior musculofascial plate reconstruction (PMPR) procedure in laparoscopic radical prostatectomy (LRP). Prior to 2010, four operative procedures were used to expedite continence recovery: preserving the fascia covering the levator ani muscle, preserving the bladder neck, securing a functional urethral length by using a lateral-view dissection technique and suspending the vesicourethral anastomosis from the puboprostatic ligaments.… Show more
“…Finally, of the 22 studies defined eligible for the qualitative analysis, one was excluded because of a lack of standardised reporting of the continence recovery outcome (Fig. ), leaving 21 studies .…”
Section: Resultsmentioning
confidence: 99%
“…Table shows the outcomes of urinary continence in the studies included in the meta‐analysis, at 3–7, 30,45–75 90, 180 days and 1 year after removal of urinary catheter in patients undergoing RP (ORP, LRP or RARP) with or without PR of the rhabdosphincter. Table summarises the different surgical techniques used in the studies comprised in the meta‐analyses.…”
Section: Resultsmentioning
confidence: 99%
“…Table shows the percentage of PSM estimated by the studies included in the meta‐analysis. The overall meta‐analysis of data in the various studies showed a rate of PSM comparable in the group of patients undergoing PR and in the group of patients undergoing standard RP (RR 1.04, 95% CI 0.82–1.31; P = 0.804; Fig.…”
To evaluate the influence of posterior musculofascial plate reconstruction (PR) on early return of continence after radical prostatectomy (RP); an updated systematic review of the literature. A systematic review of the literature was performed in June 2015, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and searching Medline, Embase, Scopus and Web of Science databases. We searched the terms posterior reconstruction prostatectomy, double layer anastomosis prostatectomy across the 'Title' and 'Abstract' fields of the records, with the following limits: humans, gender (male), and language (English). The authors reviewed the records to identify studies comparing cohorts of patients who underwent RP with or without restoration of the posterior aspect of the rhabdosphincter. A meta-analysis of the risk ratios estimated using data from the selected studies was performed. In all, 21 studies were identified, including three randomised controlled trials. The overall analysis of comparative studies showed that PR improved early continence recovery at 3-7, 30, and 90 days after catheter removal, while the continence rate at 180 days was statistically but not clinically affected. Statistically significantly lower anastomotic leakage rates were described after PR. There were no significant differences for positive surgical margins rates or for complications such as acute urinary retention and bladder neck stricture. The analysis confirms the benefits at 30 days after catheter removal already discussed in the review published in 2012, but also shows a significant advantage in terms of urinary continence recovery in the first 90 days. A multicentre prospective randomised controlled trial is currently being conducted in several institutions around the world to better assess the effectiveness of PR in facilitating an earlier recovery of postoperative urinary continence.
“…Finally, of the 22 studies defined eligible for the qualitative analysis, one was excluded because of a lack of standardised reporting of the continence recovery outcome (Fig. ), leaving 21 studies .…”
Section: Resultsmentioning
confidence: 99%
“…Table shows the outcomes of urinary continence in the studies included in the meta‐analysis, at 3–7, 30,45–75 90, 180 days and 1 year after removal of urinary catheter in patients undergoing RP (ORP, LRP or RARP) with or without PR of the rhabdosphincter. Table summarises the different surgical techniques used in the studies comprised in the meta‐analyses.…”
Section: Resultsmentioning
confidence: 99%
“…Table shows the percentage of PSM estimated by the studies included in the meta‐analysis. The overall meta‐analysis of data in the various studies showed a rate of PSM comparable in the group of patients undergoing PR and in the group of patients undergoing standard RP (RR 1.04, 95% CI 0.82–1.31; P = 0.804; Fig.…”
To evaluate the influence of posterior musculofascial plate reconstruction (PR) on early return of continence after radical prostatectomy (RP); an updated systematic review of the literature. A systematic review of the literature was performed in June 2015, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and searching Medline, Embase, Scopus and Web of Science databases. We searched the terms posterior reconstruction prostatectomy, double layer anastomosis prostatectomy across the 'Title' and 'Abstract' fields of the records, with the following limits: humans, gender (male), and language (English). The authors reviewed the records to identify studies comparing cohorts of patients who underwent RP with or without restoration of the posterior aspect of the rhabdosphincter. A meta-analysis of the risk ratios estimated using data from the selected studies was performed. In all, 21 studies were identified, including three randomised controlled trials. The overall analysis of comparative studies showed that PR improved early continence recovery at 3-7, 30, and 90 days after catheter removal, while the continence rate at 180 days was statistically but not clinically affected. Statistically significantly lower anastomotic leakage rates were described after PR. There were no significant differences for positive surgical margins rates or for complications such as acute urinary retention and bladder neck stricture. The analysis confirms the benefits at 30 days after catheter removal already discussed in the review published in 2012, but also shows a significant advantage in terms of urinary continence recovery in the first 90 days. A multicentre prospective randomised controlled trial is currently being conducted in several institutions around the world to better assess the effectiveness of PR in facilitating an earlier recovery of postoperative urinary continence.
“…Seven of these trials were RCTs 9 , 15 , 31 , 32 , 37 , 38 , 40 . Six trials 11 , 18 , 25 , 29 , 32 , 33 evaluated IPSS and EPIC urinary domain scores. Figure 1 Selecting the flowchart for the inclusion of studies in the meta-analysis.…”
Radical prostatectomy (RP) is the gold standard for the treatment of localized PCa. A meta-analysis was conducted to evaluate the effect of different techniques of pelvic floor reconstruction on urinary continence. A comprehensive search was made for trials that evaluated the efficacy of pelvic floor reconstruction. Relevant databases included PubMed, Embase, Cochrane, Ovid, Web of Science databases and relevant trials from the references. Random-effects model was used to estimate risk ratios (RRs) statistics. Pooled results of patients treated with posterior reconstruction (PR) demonstrated complete urinary continence improved at 1–4, 28–42, 90, 180 and 360 days following catheter removal. Anterior suspension (AS) was associated with improvement only at 28–42 days. The anterior reconstruction (AR) + PR was associated with urinary continence at 1–4, 90 and 180 days. AS + PR was not associated with any benefit. And PR improved social urinary continence at 7–14 and 28–42 days. No benefit was associated with AS. AR + PR had better outcomes at 90 and 180 days. AS + PR was significant improved at 28–42 and 90 days. Patients who underwent RP and PR had the least urinary incontinence. No significant benefit was observed after AS. AR + PR and AS + PR had little benefit in the post-operative period.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
