Early recovery of urinary continence after robot‐assisted radical prostatectomy is associated with membranous urethra and neurovascular bundle preservation
Objectives We investigated the correlation between surgical outcomes and postoperative urinary continence recovery in robot‐assisted radical prostatectomy (RARP). Methods Patients who underwent RARP in our institution (n = 195) were included in this study. Preserved urethral length (PUL) was assesse...
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| Veröffentlicht in: | International journal of urology 2024-05, Vol.31 (5), p.492-499 |
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| creator | Ando, Satoshi Sugihara, Toru Hinotsu, Shiro Kishino, Hiroto Hirata, Daichi Watanabe, Risako Yanase, Atsushi Yokoyama, Hirotaka Hoshina, Hayato Endo, Kaori Kamei, Jun Takaoka, Eiichiro Fujimura, Tetsuya |
| description | Objectives
We investigated the correlation between surgical outcomes and postoperative urinary continence recovery in robot‐assisted radical prostatectomy (RARP).
Methods
Patients who underwent RARP in our institution (n = 195) were included in this study. Preserved urethral length (PUL) was assessed during the procedure. Other outcomes of the surgical procedure were collected from operative records. Kaplan–Meier analysis with log‐rank test was used to compare urinary continence recovery rate with the PUL, sparing of the neurovascular bundle (NVB), and other surgical procedures. Univariate and multivariate analyses were performed using Cox proportional hazards model, and p‐values of |
| doi_str_mv | 10.1111/iju.15388 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11524102</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2913082913</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4448-8592ab5d53cc50beb4f237c27adc5904e5c5f27dd942c56ef8781d0f247d24c93</originalsourceid><addsrcrecordid>eNp1kcFu1DAQhi0EokvhwAsgS1zgkNZ27E1yQlXVQlElLvRsTewJ61ViL7az1d54BF6Al-uT4GVLBUj4YI_kT59m5ifkJWcnvJxTt55PuKrb9hFZcClFJZgUj8mCdbyrWt6II_IspTVjvBa8fUqO6pZ3SyGbBflxAXHc0YgmbDHuaBjoHJ2HUprgs_PoDVIYMkYaQx_y3bfvkJJLGS2NYJ2BkW5iSBkymhymHXWJFiIYB3vm1uUVnXDqI_gwp2LHvIpAwVvqcY5hC8nMI0Taz96OWGSYMG4hu-CfkycDjAlf3L_H5Oby4vP5h-r60_ur87Prykgp26pVnYBeWVUbo1iPvRxE3RjRgDWqYxKVUYNorO2kMGqJQ9u03LKhbMAKabr6mLw7eDdzP6E16HOEUW-im8omdACn__7xbqW_hK3mXAnJmSiGN_eGGL7OmLKeXDI4juCxjK1Fx2vW7u-Cvv4HXYc5-jKfrpliUnG5ZIV6e6BMWW6KODx0w5nep65L6vpX6oV99Wf7D-TvmAtwegBu3Yi7_5v01cebg_InxYC9jg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3050451460</pqid></control><display><type>article</type><title>Early recovery of urinary continence after robot‐assisted radical prostatectomy is associated with membranous urethra and neurovascular bundle preservation</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Ando, Satoshi ; Sugihara, Toru ; Hinotsu, Shiro ; Kishino, Hiroto ; Hirata, Daichi ; Watanabe, Risako ; Yanase, Atsushi ; Yokoyama, Hirotaka ; Hoshina, Hayato ; Endo, Kaori ; Kamei, Jun ; Takaoka, Eiichiro ; Fujimura, Tetsuya</creator><creatorcontrib>Ando, Satoshi ; Sugihara, Toru ; Hinotsu, Shiro ; Kishino, Hiroto ; Hirata, Daichi ; Watanabe, Risako ; Yanase, Atsushi ; Yokoyama, Hirotaka ; Hoshina, Hayato ; Endo, Kaori ; Kamei, Jun ; Takaoka, Eiichiro ; Fujimura, Tetsuya</creatorcontrib><description>Objectives
We investigated the correlation between surgical outcomes and postoperative urinary continence recovery in robot‐assisted radical prostatectomy (RARP).
Methods
Patients who underwent RARP in our institution (n = 195) were included in this study. Preserved urethral length (PUL) was assessed during the procedure. Other outcomes of the surgical procedure were collected from operative records. Kaplan–Meier analysis with log‐rank test was used to compare urinary continence recovery rate with the PUL, sparing of the neurovascular bundle (NVB), and other surgical procedures. Univariate and multivariate analyses were performed using Cox proportional hazards model, and p‐values of <0.05 were considered significant.
Results
Patients with a PUL ≥26 mm had 10.0%, 24.7%, 36.6%, and 89.0% continence recovery rates at 30, 60, 90, and 365 days after surgery, respectively, while patients with a PUL <26 mm had 0%, 17.8%, 26.1%, and 80.9% recovery rates, respectively. Kaplan–Meier curves showed significantly better postoperative urinary continence recovery at 30 days after RARP in patients with a PUL ≥26 mm than those with a PUL <26 mm (p = 0.0028) and in patients with NVB preservation than those with no NVB preservation (p = 0.014). Urinary continence recovery within 30, 60, and 90 days after surgery was 90.6% for patients with a PUL of ≥26 mm and NVB preservation, while only 82.3% for patients with a PUL of <26 mm or no NVB preservation.
Conclusion
Our results suggest that a PUL ≥26 mm and NVB preservation after RARP correlate with a significantly higher postoperative rate of recovery of urinary continence.</description><identifier>ISSN: 0919-8172</identifier><identifier>ISSN: 1442-2042</identifier><identifier>EISSN: 1442-2042</identifier><identifier>DOI: 10.1111/iju.15388</identifier><identifier>PMID: 38196247</identifier><language>eng</language><publisher>Australia: Wiley Subscription Services, Inc</publisher><subject>Aged ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Organ Sparing Treatments - adverse effects ; Organ Sparing Treatments - methods ; Original ; Original : Clinical Investigation ; Postoperative Complications - etiology ; Postoperative Complications - prevention & control ; Preservation ; Prostate - innervation ; Prostate - surgery ; prostate neoplasm ; Prostatectomy ; Prostatectomy - adverse effects ; Prostatectomy - methods ; Prostatic Neoplasms - surgery ; Recovery of Function ; Retrospective Studies ; robotic surgical procedures ; Robotic Surgical Procedures - adverse effects ; Robotic Surgical Procedures - methods ; Surgery ; Surgical outcomes ; Treatment Outcome ; Urethra ; Urethra - innervation ; Urethra - surgery ; urinary incontinence ; Urinary Incontinence - etiology ; Urinary Incontinence - prevention & control</subject><ispartof>International journal of urology, 2024-05, Vol.31 (5), p.492-499</ispartof><rights>2024 The Authors. published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Urological Association.</rights><rights>2024 The Authors. International Journal of Urology published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Urological Association.</rights><rights>2024. This article is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4448-8592ab5d53cc50beb4f237c27adc5904e5c5f27dd942c56ef8781d0f247d24c93</citedby><cites>FETCH-LOGICAL-c4448-8592ab5d53cc50beb4f237c27adc5904e5c5f27dd942c56ef8781d0f247d24c93</cites><orcidid>0000-0002-3421-8273 ; 0009-0009-5067-0241 ; 0000-0001-9964-1219</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fiju.15388$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fiju.15388$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,1416,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38196247$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ando, Satoshi</creatorcontrib><creatorcontrib>Sugihara, Toru</creatorcontrib><creatorcontrib>Hinotsu, Shiro</creatorcontrib><creatorcontrib>Kishino, Hiroto</creatorcontrib><creatorcontrib>Hirata, Daichi</creatorcontrib><creatorcontrib>Watanabe, Risako</creatorcontrib><creatorcontrib>Yanase, Atsushi</creatorcontrib><creatorcontrib>Yokoyama, Hirotaka</creatorcontrib><creatorcontrib>Hoshina, Hayato</creatorcontrib><creatorcontrib>Endo, Kaori</creatorcontrib><creatorcontrib>Kamei, Jun</creatorcontrib><creatorcontrib>Takaoka, Eiichiro</creatorcontrib><creatorcontrib>Fujimura, Tetsuya</creatorcontrib><title>Early recovery of urinary continence after robot‐assisted radical prostatectomy is associated with membranous urethra and neurovascular bundle preservation</title><title>International journal of urology</title><addtitle>Int J Urol</addtitle><description>Objectives
We investigated the correlation between surgical outcomes and postoperative urinary continence recovery in robot‐assisted radical prostatectomy (RARP).
Methods
Patients who underwent RARP in our institution (n = 195) were included in this study. Preserved urethral length (PUL) was assessed during the procedure. Other outcomes of the surgical procedure were collected from operative records. Kaplan–Meier analysis with log‐rank test was used to compare urinary continence recovery rate with the PUL, sparing of the neurovascular bundle (NVB), and other surgical procedures. Univariate and multivariate analyses were performed using Cox proportional hazards model, and p‐values of <0.05 were considered significant.
Results
Patients with a PUL ≥26 mm had 10.0%, 24.7%, 36.6%, and 89.0% continence recovery rates at 30, 60, 90, and 365 days after surgery, respectively, while patients with a PUL <26 mm had 0%, 17.8%, 26.1%, and 80.9% recovery rates, respectively. Kaplan–Meier curves showed significantly better postoperative urinary continence recovery at 30 days after RARP in patients with a PUL ≥26 mm than those with a PUL <26 mm (p = 0.0028) and in patients with NVB preservation than those with no NVB preservation (p = 0.014). Urinary continence recovery within 30, 60, and 90 days after surgery was 90.6% for patients with a PUL of ≥26 mm and NVB preservation, while only 82.3% for patients with a PUL of <26 mm or no NVB preservation.
Conclusion
Our results suggest that a PUL ≥26 mm and NVB preservation after RARP correlate with a significantly higher postoperative rate of recovery of urinary continence.</description><subject>Aged</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Organ Sparing Treatments - adverse effects</subject><subject>Organ Sparing Treatments - methods</subject><subject>Original</subject><subject>Original : Clinical Investigation</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - prevention & control</subject><subject>Preservation</subject><subject>Prostate - innervation</subject><subject>Prostate - surgery</subject><subject>prostate neoplasm</subject><subject>Prostatectomy</subject><subject>Prostatectomy - adverse effects</subject><subject>Prostatectomy - methods</subject><subject>Prostatic Neoplasms - surgery</subject><subject>Recovery of Function</subject><subject>Retrospective Studies</subject><subject>robotic surgical procedures</subject><subject>Robotic Surgical Procedures - adverse effects</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Treatment Outcome</subject><subject>Urethra</subject><subject>Urethra - innervation</subject><subject>Urethra - surgery</subject><subject>urinary incontinence</subject><subject>Urinary Incontinence - etiology</subject><subject>Urinary Incontinence - prevention & control</subject><issn>0919-8172</issn><issn>1442-2042</issn><issn>1442-2042</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNp1kcFu1DAQhi0EokvhwAsgS1zgkNZ27E1yQlXVQlElLvRsTewJ61ViL7az1d54BF6Al-uT4GVLBUj4YI_kT59m5ifkJWcnvJxTt55PuKrb9hFZcClFJZgUj8mCdbyrWt6II_IspTVjvBa8fUqO6pZ3SyGbBflxAXHc0YgmbDHuaBjoHJ2HUprgs_PoDVIYMkYaQx_y3bfvkJJLGS2NYJ2BkW5iSBkymhymHXWJFiIYB3vm1uUVnXDqI_gwp2LHvIpAwVvqcY5hC8nMI0Taz96OWGSYMG4hu-CfkycDjAlf3L_H5Oby4vP5h-r60_ur87Prykgp26pVnYBeWVUbo1iPvRxE3RjRgDWqYxKVUYNorO2kMGqJQ9u03LKhbMAKabr6mLw7eDdzP6E16HOEUW-im8omdACn__7xbqW_hK3mXAnJmSiGN_eGGL7OmLKeXDI4juCxjK1Fx2vW7u-Cvv4HXYc5-jKfrpliUnG5ZIV6e6BMWW6KODx0w5nep65L6vpX6oV99Wf7D-TvmAtwegBu3Yi7_5v01cebg_InxYC9jg</recordid><startdate>202405</startdate><enddate>202405</enddate><creator>Ando, Satoshi</creator><creator>Sugihara, Toru</creator><creator>Hinotsu, Shiro</creator><creator>Kishino, Hiroto</creator><creator>Hirata, Daichi</creator><creator>Watanabe, Risako</creator><creator>Yanase, Atsushi</creator><creator>Yokoyama, Hirotaka</creator><creator>Hoshina, Hayato</creator><creator>Endo, Kaori</creator><creator>Kamei, Jun</creator><creator>Takaoka, Eiichiro</creator><creator>Fujimura, Tetsuya</creator><general>Wiley Subscription Services, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3421-8273</orcidid><orcidid>https://orcid.org/0009-0009-5067-0241</orcidid><orcidid>https://orcid.org/0000-0001-9964-1219</orcidid></search><sort><creationdate>202405</creationdate><title>Early recovery of urinary continence after robot‐assisted radical prostatectomy is associated with membranous urethra and neurovascular bundle preservation</title><author>Ando, Satoshi ; Sugihara, Toru ; Hinotsu, Shiro ; Kishino, Hiroto ; Hirata, Daichi ; Watanabe, Risako ; Yanase, Atsushi ; Yokoyama, Hirotaka ; Hoshina, Hayato ; Endo, Kaori ; Kamei, Jun ; Takaoka, Eiichiro ; Fujimura, Tetsuya</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4448-8592ab5d53cc50beb4f237c27adc5904e5c5f27dd942c56ef8781d0f247d24c93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Organ Sparing Treatments - adverse effects</topic><topic>Organ Sparing Treatments - methods</topic><topic>Original</topic><topic>Original : Clinical Investigation</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - prevention & control</topic><topic>Preservation</topic><topic>Prostate - innervation</topic><topic>Prostate - surgery</topic><topic>prostate neoplasm</topic><topic>Prostatectomy</topic><topic>Prostatectomy - adverse effects</topic><topic>Prostatectomy - methods</topic><topic>Prostatic Neoplasms - surgery</topic><topic>Recovery of Function</topic><topic>Retrospective Studies</topic><topic>robotic surgical procedures</topic><topic>Robotic Surgical Procedures - adverse effects</topic><topic>Robotic Surgical Procedures - methods</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Treatment Outcome</topic><topic>Urethra</topic><topic>Urethra - innervation</topic><topic>Urethra - surgery</topic><topic>urinary incontinence</topic><topic>Urinary Incontinence - etiology</topic><topic>Urinary Incontinence - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ando, Satoshi</creatorcontrib><creatorcontrib>Sugihara, Toru</creatorcontrib><creatorcontrib>Hinotsu, Shiro</creatorcontrib><creatorcontrib>Kishino, Hiroto</creatorcontrib><creatorcontrib>Hirata, Daichi</creatorcontrib><creatorcontrib>Watanabe, Risako</creatorcontrib><creatorcontrib>Yanase, Atsushi</creatorcontrib><creatorcontrib>Yokoyama, Hirotaka</creatorcontrib><creatorcontrib>Hoshina, Hayato</creatorcontrib><creatorcontrib>Endo, Kaori</creatorcontrib><creatorcontrib>Kamei, Jun</creatorcontrib><creatorcontrib>Takaoka, Eiichiro</creatorcontrib><creatorcontrib>Fujimura, Tetsuya</creatorcontrib><collection>Wiley-Blackwell Open Access Titles</collection><collection>Wiley Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ando, Satoshi</au><au>Sugihara, Toru</au><au>Hinotsu, Shiro</au><au>Kishino, Hiroto</au><au>Hirata, Daichi</au><au>Watanabe, Risako</au><au>Yanase, Atsushi</au><au>Yokoyama, Hirotaka</au><au>Hoshina, Hayato</au><au>Endo, Kaori</au><au>Kamei, Jun</au><au>Takaoka, Eiichiro</au><au>Fujimura, Tetsuya</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early recovery of urinary continence after robot‐assisted radical prostatectomy is associated with membranous urethra and neurovascular bundle preservation</atitle><jtitle>International journal of urology</jtitle><addtitle>Int J Urol</addtitle><date>2024-05</date><risdate>2024</risdate><volume>31</volume><issue>5</issue><spage>492</spage><epage>499</epage><pages>492-499</pages><issn>0919-8172</issn><issn>1442-2042</issn><eissn>1442-2042</eissn><abstract>Objectives
We investigated the correlation between surgical outcomes and postoperative urinary continence recovery in robot‐assisted radical prostatectomy (RARP).
Methods
Patients who underwent RARP in our institution (n = 195) were included in this study. Preserved urethral length (PUL) was assessed during the procedure. Other outcomes of the surgical procedure were collected from operative records. Kaplan–Meier analysis with log‐rank test was used to compare urinary continence recovery rate with the PUL, sparing of the neurovascular bundle (NVB), and other surgical procedures. Univariate and multivariate analyses were performed using Cox proportional hazards model, and p‐values of <0.05 were considered significant.
Results
Patients with a PUL ≥26 mm had 10.0%, 24.7%, 36.6%, and 89.0% continence recovery rates at 30, 60, 90, and 365 days after surgery, respectively, while patients with a PUL <26 mm had 0%, 17.8%, 26.1%, and 80.9% recovery rates, respectively. Kaplan–Meier curves showed significantly better postoperative urinary continence recovery at 30 days after RARP in patients with a PUL ≥26 mm than those with a PUL <26 mm (p = 0.0028) and in patients with NVB preservation than those with no NVB preservation (p = 0.014). Urinary continence recovery within 30, 60, and 90 days after surgery was 90.6% for patients with a PUL of ≥26 mm and NVB preservation, while only 82.3% for patients with a PUL of <26 mm or no NVB preservation.
Conclusion
Our results suggest that a PUL ≥26 mm and NVB preservation after RARP correlate with a significantly higher postoperative rate of recovery of urinary continence.</abstract><cop>Australia</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38196247</pmid><doi>10.1111/iju.15388</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-3421-8273</orcidid><orcidid>https://orcid.org/0009-0009-5067-0241</orcidid><orcidid>https://orcid.org/0000-0001-9964-1219</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0919-8172 |
| ispartof | International journal of urology, 2024-05, Vol.31 (5), p.492-499 |
| issn | 0919-8172 1442-2042 1442-2042 |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aged Humans Kaplan-Meier Estimate Male Middle Aged Organ Sparing Treatments - adverse effects Organ Sparing Treatments - methods Original Original : Clinical Investigation Postoperative Complications - etiology Postoperative Complications - prevention & control Preservation Prostate - innervation Prostate - surgery prostate neoplasm Prostatectomy Prostatectomy - adverse effects Prostatectomy - methods Prostatic Neoplasms - surgery Recovery of Function Retrospective Studies robotic surgical procedures Robotic Surgical Procedures - adverse effects Robotic Surgical Procedures - methods Surgery Surgical outcomes Treatment Outcome Urethra Urethra - innervation Urethra - surgery urinary incontinence Urinary Incontinence - etiology Urinary Incontinence - prevention & control |
| title | Early recovery of urinary continence after robot‐assisted radical prostatectomy is associated with membranous urethra and neurovascular bundle preservation |
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