#1042

Comparison of urinary continence rates between three different vesicourethral anastomosis procedures in robotic-assisted radical prostatectomy: Simple anastomosis with barbed suture, tennis-racket bladder reconstruction, and Van Velthoven anastomosis

Yiwei Su¹, Thomas Y. Hsueh¹, Shu-Wen Li¹, Andy C. Huang¹, Kuo-Wei Kao¹, Yu-Wei Lai¹, Yi-Jiun Hsiao¹, Shiou-Sheng Chen¹, Allen W. Chiu¹

¹ Taipei City Hospital Ren Ai branch, Department of Surgery, Division of Urology, Taipei

Introduction:
Robotic-assisted radical prostatectomy (RARP) is the current gold standard treatment for early-stage prostate cancer. The most common side effect of RARP is urinary incontinence. Therefore, many different surgical techniques have been developed in recent years to improve urinary continence rates. Our study aimed to compare three different techniques of vesicourethral anastomosis in robotic-assisted radical prostatectomy: simple anastomosis with simple anastomosis with barbed suture, tennis-racket bladder reconstruction, and Van Velthoven anastomosis.

Materials and Methods:
We recruited patients who underwent RARP for prostate cancer at our institute between January 2021 and March 2023. A total of 81 patients were included. Simple anastomosis with barbed suture was defined as using 3-4 interrupted barbed sutures to perform the anastomosis. Tennis-racket bladder reconstruction was defined as using Vicryl sutures for bladder reconstruction, combined with Van Velthoven anastomosis. Van Velthoven anastomosis was defined as using one bidirectional barbed suture for both clockwise and counterclockwise anastomosis. We compared patient characteristics, surgical techniques, and postoperative urinary continence rates between the groups. Continuous variables were assessed for normality using the Student's t-test, while categorical variables were analyzed with the chi-squared test. Statistical analyses were performed using IBM SPSS software, with p < 0.05 considered statistically significant.

Results:
There were no significant differences in patient characteristics between the groups. We found that both tennis-racket bladder reconstruction, and Van Velthoven anastomosis showed better urinary continence rates than simple anastomosis with barbed sutures. However, there was no significant difference between the two groups.