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Endopelvic fascia preservation during robot-assisted laparoscopic radical prostatectomy: Does it affect urinary incontinence?
MedLine Citation:
PMID:  25008957     Owner:  NLM     Status:  Publisher    
Abstract Objective. Urinary incontinence has a significant impact on the quality of life after radical prostatectomy. This study aimed to determine whether preserving the endopelvic fascia influences subsequent urinary incontinence. Material and methods. Consecutive patients (n = 138) who underwent robot-assisted laparoscopic radical prostatectomy (RALP) for prostate cancer between October 2010 and June 2012 with a minimum of 1 year follow-up were retrospectively analysed. The subjects were divided into two groups: the non-preserved endopelvic fascia group (nPE group) and the preserved endopelvic fascia group (PE group). Continence was defined as not using any pads and having no urine leakages. Continence rates at set time-points after RALP were compared using the chi-squared test. Continence recovery rates were analysed with the Kaplan-Meier method and the log-rank test. Prognostic factors of incontinence were identified using the Cox proportional hazards model. Results. The age, body mass index, preoperative prostate-specific antigen levels, prostate volume, estimated blood loss, mean operative time, Gleason score and pathological stage were not significantly different between the two study groups. The continence rate of the nPE group and PE group was 88.4% and 97.1%, respectively, at 12 months after surgery (p = 0.049), which was also significant according to the Kaplan-Meier analysis (p < 0.001). Preservation of endopelvic fascia was the only significant prognostic factor for urinary incontinence (p = 0.002, hazard ratio = 1.867) according to the multivariate analysis. Conclusions. Endopelvic fascia preservation during RALP significantly enhances postoperative continence and is related to the speed of recovery of continence.
Se Yun Kwon; Jun Nyung Lee; Hyun Tae Kim; Tae-Hwan Kim; Bup Wan Kim; Gyu-Seog Choi; Tae Gyun Kwon
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-7-10
Journal Detail:
Title:  Scandinavian journal of urology     Volume:  -     ISSN:  2168-1813     ISO Abbreviation:  Scand J Urol     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-7-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101587186     Medline TA:  Scand J Urol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-7     Citation Subset:  -    
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