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The Impact of Lateral Bladder Neck Preservation on Urinary Continence Recovery After Robot-Assisted Radical Prostatectomy.
J Endourol. 2018 01; 32(1):40-45.JE

Abstract

OBJECTIVE

Urinary incontinence is one of the most bothersome adversities after robot-assisted radical prostatectomy (RARP). The aim of this study was to investigate the urinary continence recovery and the effect of various surgical techniques.

MATERIALS AND METHODS

We previously reported that posterior rhabdosphincter reconstruction and nerve-sparing were independent predictors of urinary continence recovery 1 month after catheter removal in 199 patients who underwent RARP. Retrospectively, we further reviewed those 199 patients for urinary continence recovery at 3 months or later after RARP. The relationships of urinary continence with perioperative findings, including surgical procedures, were evaluated at 3 to 12 months after RARP. The Fisher exact test and Mann-Whitney rank sum test were used for evaluating variables between the groups. Multivariate logistic regression analysis was performed to investigate the association between urinary continence and perioperative factors.

RESULTS

On univariate analyses, surgeon experience, lateral bladder neck preservation (BNP), anterior reconstruction, and posterior reconstruction were significantly associated with urinary continence recovery 3 months after RARP, but only lateral BNP was independently associated with urinary continence recovery in a multivariate analysis. Similarly, on univariate analyses, surgeon experience, lateral BNP, and posterior reconstruction were significantly associated with continence recovery at 6 months or later after surgery. However, multivariate analyses showed that only lateral BNP was significantly associated with urinary continence recovery 6 months or later after surgery.

CONCLUSION

Although the lateral BNP technique did not affect immediate urinary continence recovery, this procedure was significantly associated with continence recovery 3 months or later after RARP.

Authors+Show Affiliations

1 Department of Urology, Tokyo Medical University , Tokyo, Japan .1 Department of Urology, Tokyo Medical University , Tokyo, Japan . 2 Institute for Urology , Shin-yurigaoka General Hospital, Kawasaki, Japan .1 Department of Urology, Tokyo Medical University , Tokyo, Japan .1 Department of Urology, Tokyo Medical University , Tokyo, Japan .1 Department of Urology, Tokyo Medical University , Tokyo, Japan .1 Department of Urology, Tokyo Medical University , Tokyo, Japan . 3 Department of Urology, Sanno Hospital , Tokyo, Japan . 4 Clinical Medicine Research Center, International University of Health and Welfare , Tokyo, Japan .1 Department of Urology, Tokyo Medical University , Tokyo, Japan .1 Department of Urology, Tokyo Medical University , Tokyo, Japan .

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28978229

Citation

Hashimoto, Takeshi, et al. "The Impact of Lateral Bladder Neck Preservation On Urinary Continence Recovery After Robot-Assisted Radical Prostatectomy." Journal of Endourology, vol. 32, no. 1, 2018, pp. 40-45.
Hashimoto T, Yoshioka K, Gondo T, et al. The Impact of Lateral Bladder Neck Preservation on Urinary Continence Recovery After Robot-Assisted Radical Prostatectomy. J Endourol. 2018;32(1):40-45.
Hashimoto, T., Yoshioka, K., Gondo, T., Hasama, K., Hirasawa, Y., Nakashima, J., Tachibana, M., & Ohno, Y. (2018). The Impact of Lateral Bladder Neck Preservation on Urinary Continence Recovery After Robot-Assisted Radical Prostatectomy. Journal of Endourology, 32(1), 40-45. https://doi.org/10.1089/end.2017.0459
Hashimoto T, et al. The Impact of Lateral Bladder Neck Preservation On Urinary Continence Recovery After Robot-Assisted Radical Prostatectomy. J Endourol. 2018;32(1):40-45. PubMed PMID: 28978229.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Impact of Lateral Bladder Neck Preservation on Urinary Continence Recovery After Robot-Assisted Radical Prostatectomy. AU - Hashimoto,Takeshi, AU - Yoshioka,Kunihiko, AU - Gondo,Tatsuo, AU - Hasama,Kazuki, AU - Hirasawa,Yosuke, AU - Nakashima,Jun, AU - Tachibana,Masaaki, AU - Ohno,Yoshio, Y1 - 2017/11/03/ PY - 2017/10/6/pubmed PY - 2019/2/16/medline PY - 2017/10/6/entrez KW - bladder neck preservation KW - robot-assisted radical prostatectomy KW - urinary continence recovery SP - 40 EP - 45 JF - Journal of endourology JO - J. Endourol. VL - 32 IS - 1 N2 - OBJECTIVE: Urinary incontinence is one of the most bothersome adversities after robot-assisted radical prostatectomy (RARP). The aim of this study was to investigate the urinary continence recovery and the effect of various surgical techniques. MATERIALS AND METHODS: We previously reported that posterior rhabdosphincter reconstruction and nerve-sparing were independent predictors of urinary continence recovery 1 month after catheter removal in 199 patients who underwent RARP. Retrospectively, we further reviewed those 199 patients for urinary continence recovery at 3 months or later after RARP. The relationships of urinary continence with perioperative findings, including surgical procedures, were evaluated at 3 to 12 months after RARP. The Fisher exact test and Mann-Whitney rank sum test were used for evaluating variables between the groups. Multivariate logistic regression analysis was performed to investigate the association between urinary continence and perioperative factors. RESULTS: On univariate analyses, surgeon experience, lateral bladder neck preservation (BNP), anterior reconstruction, and posterior reconstruction were significantly associated with urinary continence recovery 3 months after RARP, but only lateral BNP was independently associated with urinary continence recovery in a multivariate analysis. Similarly, on univariate analyses, surgeon experience, lateral BNP, and posterior reconstruction were significantly associated with continence recovery at 6 months or later after surgery. However, multivariate analyses showed that only lateral BNP was significantly associated with urinary continence recovery 6 months or later after surgery. CONCLUSION: Although the lateral BNP technique did not affect immediate urinary continence recovery, this procedure was significantly associated with continence recovery 3 months or later after RARP. SN - 1557-900X UR - https://www.unboundmedicine.com/medline/citation/28978229/The_Impact_of_Lateral_Bladder_Neck_Preservation_on_Urinary_Continence_Recovery_After_Robot_Assisted_Radical_Prostatectomy_ L2 - https://www.liebertpub.com/doi/full/10.1089/end.2017.0459?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -