Simple suturing of the bladder neck muscle layer at the vesicourethral anastomosis site to the dorsal vein complex during anterior reconstruction led to a better postoperative urinary continence after robot-assisted laparoscopic prostatectomy

Fukui, Shinji; Kagebayashi, Yoriaki; Iemura, Yusuke; Tatsumi, Yoshihiro; Matsumura, Yoshiaki; Samma, Shoji

doi:10.1080/21681805.2020.1819409

Cited by 1 publication

(1 citation statement)

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“…(2) Anastomosis of the bladder and urethra: since the periprostatic fascia is not separated in the posterior approach RALP, there is tension in the anastomosis between the urethra and the urethra, and the bottom-up reverse field of view is required during the anastomosis process requiring the clinician's suturing skills (21,22). Given these operational difficulties, intrafascial radical resection of the prostate through an anterior approach was performed to preserve important urinary continence-related tissue structures in the Retzius space.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of the transvesical approach for robotic-assisted radical prostatectomy via a bladder neck and prostate combined longitudinal incision for the treatment of localized prostate cancer

et al. 2023

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ObjectiveThis study explores the feasibility and safety of the transvesical approach of robotic-assisted radical prostatectomy via a bladder neck and prostate combined longitudinal incision.MethodsFrom June 2017 to May 2021, 41 patients aged from 51 to 69 years underwent the transvesical approach of robotic-assisted radical prostatectomy via a bladder neck and prostate combined longitudinal incision (L-RALP). The prostate volume was 22.0–57.8 ml (mean: 36.3 ± 11.1 ml), with a preoperative PSA value of 3.7–12.3 ng/ml (mean: 7.3 ± 1.2 ng/mL). All preoperative Gleason scores were less than or equal to 7 points, and the preoperative TNM stage ranged from T2a to T2b. All patients were diagnosed with prostate cancer by preoperative prostate biopsy or postoperative pathological specimens after prostatectomy. The operation, blood loss, hospitalization, erectile function and postoperative urinary continence were recorded. Patients were defined as continent if they answered “zero pad” per day, and they were invited to fill out The International Consultation on Incontinence Questionnaire (ICI-Q-SF) after the catheter removal at 4 and 24 weeks.ResultsAll the operations were completed by robotic-assisted radical prostatectomy without transition to open surgery. The surgery time was 105–131 min (mean: 111.3 ± 14.9 min), with an estimated blood loss of 50–220 ml (mean: 95.5 ± 27.3 ml). The postoperative hospital stay was 3–8 days (mean: 5.2 ± 1.7 days), and the postoperative catheter was removed after 5–7 days (mean: 6.3 ± 1.1 days). After 24 weeks of follow-up, 35 cases (85.4%, 35/41) obtained immediate urinary continence after the catheter removal in 24h. All patients had regained continence 24 weeks postoperatively (100%, 41/41).ConclusionThe transvesical approach of robotic-assisted radical prostatectomy via a bladder neck and prostate combined longitudinal incision is a safe and effective surgical technique, beneficial for early continence recovery and erectile function, and it is also suitable for prostate cancer patients after prostate enucleation.

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Section: Discussionmentioning

confidence: 99%