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Retzius Sparing Robot-Assisted Radical Prostatectomy Conveys Early Regain of Continence over Conventional Robot-Assisted Radical Prostatectomy: A Propensity Score Matched Analysis of 1,863 Patients.
J Urol. 2020 01; 203(1):137-144.JU

Abstract

PURPOSE

We compared early continence recovery after surgical treatment of prostate cancer with Retzius sparing robot-assisted radical prostatectomy and conventional robot-assisted radical prostatectomy.

MATERIALS AND METHODS

Robot-assisted radical prostatectomy was done by a single surgeon in 1,863 cases between October 2005 and May 2018 using the conventional and the Retzius sparing technique in 1,150 and 713, respectively. To compare continence outcomes between the groups propensity score matching was performed using 9 preoperative variables, including age, body mass index, prostate specific antigen, biopsy Gleason Grade Group, clinical T stage, prostate volume on transrectal ultrasound, and the I-PSS (International Prostate Symptom Score), I-PSS quality of life score and International Index of Erectile Function-5 scores. Continence was assessed by the pad count every month postoperatively until month 6 and was converted to a binary outcome.

RESULTS

After propensity score matching 609 cases per group were matched with no significant difference in all 9 variables. The Kaplan-Meier curve analysis revealed that Retzius sparing robot-assisted radical prostatectomy was associated with a significantly better continence recovery rate than conventional robot-assisted radical prostatectomy during the 6-month study period (p <0.001).

CONCLUSIONS

Based on propensity score matching with multiple variables and a large case series, Retzius sparing robot-assisted radical prostatectomy can be a candidate for future robot-assisted radical prostatectomy. It achieves better early continence recovery, a short operative time and early recovery compared to conventional robot-assisted radical prostatectomy.

Authors+Show Affiliations

Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea.Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea.Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea.Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea.Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea.Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea.Department of Urology, Inha University School of Medicine, Incheon, South Korea.Department of Urology, Wonju Yonsei University College of Medicine, Wonju, South Korea.Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea.Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31347951

Citation

Lee, Jongsoo, et al. "Retzius Sparing Robot-Assisted Radical Prostatectomy Conveys Early Regain of Continence Over Conventional Robot-Assisted Radical Prostatectomy: a Propensity Score Matched Analysis of 1,863 Patients." The Journal of Urology, vol. 203, no. 1, 2020, pp. 137-144.
Lee J, Kim HY, Goh HJ, et al. Retzius Sparing Robot-Assisted Radical Prostatectomy Conveys Early Regain of Continence over Conventional Robot-Assisted Radical Prostatectomy: A Propensity Score Matched Analysis of 1,863 Patients. J Urol. 2020;203(1):137-144.
Lee, J., Kim, H. Y., Goh, H. J., Heo, J. E., Almujalhem, A., Alqahtani, A. A., Chung, D. Y., Chang, K., Choi, Y. D., & Rha, K. H. (2020). Retzius Sparing Robot-Assisted Radical Prostatectomy Conveys Early Regain of Continence over Conventional Robot-Assisted Radical Prostatectomy: A Propensity Score Matched Analysis of 1,863 Patients. The Journal of Urology, 203(1), 137-144. https://doi.org/10.1097/JU.0000000000000461
Lee J, et al. Retzius Sparing Robot-Assisted Radical Prostatectomy Conveys Early Regain of Continence Over Conventional Robot-Assisted Radical Prostatectomy: a Propensity Score Matched Analysis of 1,863 Patients. J Urol. 2020;203(1):137-144. PubMed PMID: 31347951.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Retzius Sparing Robot-Assisted Radical Prostatectomy Conveys Early Regain of Continence over Conventional Robot-Assisted Radical Prostatectomy: A Propensity Score Matched Analysis of 1,863 Patients. AU - Lee,Jongsoo, AU - Kim,Ha Yan, AU - Goh,Hyeok Joon, AU - Heo,Ji Eun, AU - Almujalhem,Ahmad, AU - Alqahtani,Ali A, AU - Chung,Doo Yong, AU - Chang,Kidon, AU - Choi,Young Deuk, AU - Rha,Koon Ho, Y1 - 2019/07/26/ PY - 2019/7/28/pubmed PY - 2019/12/31/medline PY - 2019/7/27/entrez KW - organ sparing treatments KW - prostatectomy KW - prostatic neoplasms KW - robotic surgical procedures KW - urinary incontinence SP - 137 EP - 144 JF - The Journal of urology JO - J. Urol. VL - 203 IS - 1 N2 - PURPOSE: We compared early continence recovery after surgical treatment of prostate cancer with Retzius sparing robot-assisted radical prostatectomy and conventional robot-assisted radical prostatectomy. MATERIALS AND METHODS: Robot-assisted radical prostatectomy was done by a single surgeon in 1,863 cases between October 2005 and May 2018 using the conventional and the Retzius sparing technique in 1,150 and 713, respectively. To compare continence outcomes between the groups propensity score matching was performed using 9 preoperative variables, including age, body mass index, prostate specific antigen, biopsy Gleason Grade Group, clinical T stage, prostate volume on transrectal ultrasound, and the I-PSS (International Prostate Symptom Score), I-PSS quality of life score and International Index of Erectile Function-5 scores. Continence was assessed by the pad count every month postoperatively until month 6 and was converted to a binary outcome. RESULTS: After propensity score matching 609 cases per group were matched with no significant difference in all 9 variables. The Kaplan-Meier curve analysis revealed that Retzius sparing robot-assisted radical prostatectomy was associated with a significantly better continence recovery rate than conventional robot-assisted radical prostatectomy during the 6-month study period (p <0.001). CONCLUSIONS: Based on propensity score matching with multiple variables and a large case series, Retzius sparing robot-assisted radical prostatectomy can be a candidate for future robot-assisted radical prostatectomy. It achieves better early continence recovery, a short operative time and early recovery compared to conventional robot-assisted radical prostatectomy. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/31347951/Retzius_Sparing_Robot_Assisted_Radical_Prostatectomy_Conveys_Early_Regain_of_Continence_over_Conventional_Robot_Assisted_Radical_Prostatectomy:_A_Propensity_Score_Matched_Analysis_of_1863_Patients_ L2 - https://www.jurology.com/doi/full/10.1097/JU.0000000000000461?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -