奇美醫學中心 外科部 泌尿外科 ，1泌尿腫瘤科
Posterior reconstruction with suspension technique to improve early continence after robotic-assisted laparoscopic radical prostatectomy: our hospital experience
Kau Han Lee, Steven Kuan-Hua Huang1, Wei-Hong Lai, Chien-Liang Liu, Shun-Hsing Hung
Division of Urology, Department of Surgery, 1Division of Uro-Oncology
Chi-Mei Medical Center, Tainan, Taiwan
Introduction and purpose: Urinary incontinence is a significant cause of morbidity after radical prostatectomy. We present our experience of posterior reconstruction with suspension technique to improve early continence after robotic-assisted radical prostatectomy
Materials & Methods: From 2012 April to 2014 April, 50 patients underwent robotic-assisted transperitoneal laparoscopic radical prostatectomy. After the prostatectomy & prior of the urethrovesical anastomosis, posterior reconstruction was enhanced by reapproximating rhabdosphincter to the residual Denonvillier’s fascia & secured over pubic symphisis with 3-0 V-Loc suture. The continence was defined as no pad use in daily life.
Results: The mean age was 65 year-old. The mean PSA was 20.8ng/ml. The mean prostate size was 33gm. The medium console time was 226mins. Nerve sparing procedure was performed bilaterally in 19 (38%) & unilaterally in 7(14%) cases. The 1 week, 1 month, 3 month & 6 month continence rate were 30.6%, 61.2%, 87.8 & 95.9% respectively.
Conclusion: Posterior reconstruction with suspension technique after robotic-assisted radical prostatectomy is a feasible technique to improve early continence rate, thus decreasing patient’s postoperative morbidity.