Improved early continence by Retzius-sparing method for robot-assisted laparoscopic radical prostatectomy: preliminary experience of changhua christian hospital
Jian-Ting Chen, Bai-Fu Wang, Heng-Chieh Chiang, Sheng-Xian Huang, Pao-Hwa Chen, You-Chiuan Chien
Divisions of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan
Purpose: To report the technique, as well as functional and oncologic results of our preliminary experience of Retzius-sparing method for robot-assisted laparoscopic prostatectomy (RALP).
Materials and Methods: Between Febuary 2014 and March 2015, 10 RALPs with Retzius-sparing were performed at our institute. Demographic, perioperative, and postoperative data were recorded. Continence status was assessed immediately after urethral catheter removal, at the first and third month after RALP. Preprostatic structures, including endopelvic fasica and dorsal venous complex, as well as bladder neck were all preserved. The whole procedure of dissection and vesicourethral anastomosis was accomplished by totally posterior approach. Complications were classified according to the Clavien-Dindo classification.
Results: Median follow-up was 8.3±2.1 months; median age was 67.1 ± 6.5 years. Retzius-sparing method was performed in 7 patients, and 5 of them were continent immediately after catheter removal; mean duration of the catheterization was 7.4 ± 1.4 days. Furthermore, there were no complications related to the bladder neck such as bladder neck stricture, acute/chronic urinary retention, as well as no Clavien III, IV, and V complications.
Conclusion: Our preliminary experience of using Retzius-sparing method for RALP provided very early continence at the time of catheter removal and within short-term follow-up. This can help early recovery of urinary incontinence and better quality of life after RALP.