Effect of a suspension suture in addition to a total anatomical reconstruction in robot assisted laparoscopic prostatectomy: does it help early continence?

Abstract

Introduction: Continence post robotic assisted laparoscopic radical prostatectomy (RALP) is approximately 90% and many reconstructive techniques have been described to improve early continence. We assessed whether a peri-urethral suspension stitch in addition to a total anatomical repair (TAR) improved early continence. Materials and methods: We describe our procedure and assessed 68 consecutive RALP’s over a two-year period. Complete data were collected on continence rates and incontinence modular questionnaire (ICIQ) scores in 55 patients. Results: In the “no suspension stitch” (NoSS) group continence rates at 2 weeks, 6 weeks and 3 months were 11%, 48% and 81% respectively whilst in the “suspension stitch” (SS) group continence rates were 11%, 46% and 75% respectively (lowest p-value = 0.26 seen at 2 weeks). Average ICIQ scores in the NoSS group were 9.8, 6.6 and 4.3 and in the SS group were 9.4, 6.4 and 4.8 at each time frame (lowest p-value = 0.63 at 6 weeks). Conclusions: No significant difference in continence or ICIQ scores was seen between the two groups. Overall our continence rates were comparable to the published literature. The addition of a suspension stitch did not add any further benefit in improving early continence when performing a total anatomical reconstruction.