臺中榮民總醫院泌尿外科

Divisions of Urology, Department of Surgery, Taichung Veterans General Hospital

 

Purpose: We present our initial experience of Retzius-sparing robotic-assisted radical prostatectomy (Rs-RaRP) in the outcome of continence control. Also, the post-operative bladder neck to pubic symphysis (BNPS) ratio and the continent status was match-compared.

Patients and Methods: From November 2014 to March 2017, 50 patients received Rs-RaRP were compared to the other 100 patients underwent transperitoneal robotic-assisted radical prostatectomy (RaRP) by a single surgeon in the continent outcome.  The characteristics, clinical staging, and serum PSA levels between these two groups of patients were compared. Continence control is defined as no need of pad use, while the continent results were records at immediately after removal of catheter, 1month, 3 months, 6 months and 1 year after the operation, respectively. The catheters were removed on the 3^rd to 14^th post-operation day. The cystography for every patient was taken on the 2^nd to 3^rd post-operative day. The cystographic result was used to evaluate the bladder neck location by BNPS ratio and the continent status was match-compared in every patient.

Results: A total of 50 patients underwent Rs-RaRP and the other 100 patients underwent traditional transperitoneal RaRP were compared, using propensity score matching analysis. There was no difference in age, prostate size, pathology T stage and PSA between the two groups. The immediately continent control was significantly better in the group of Rs-RaRP while the BNPS ratio was significantly low in the Rs-RaRP group. However, there was no difference of continent control between there two groups of patients at one year. The independent risk factors affecting post-operative continence were age and approaching method.