MP15-14 PRESERVATION OF ENDOPELVIC FASCIA, PUBOPROSTATIC LIGAMENTS, DORSAL VENOUS COMPLEX AND HYDRODISSECTION OF THE NEUROVASCULAR BUNDLES IMPROVE RATES AND TIME TO CONTINENCE AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY: A PROPENSITY-SCORE MATCHED ANALYSIS

Abstract

You have accessJournal of UrologyCME1 May 2022MP15-14 PRESERVATION OF ENDOPELVIC FASCIA, PUBOPROSTATIC LIGAMENTS, DORSAL VENOUS COMPLEX AND HYDRODISSECTION OF THE NEUROVASCULAR BUNDLES IMPROVE RATES AND TIME TO CONTINENCE AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY: A PROPENSITY-SCORE MATCHED ANALYSIS Ahmed S. Elsayed, Yousuf Ramahi, Ayat A. Shah, Hannah B. Ely, Zhe Jing, Holly Houenstein, Julian Joseph, Sharifeh Almasaid, Gaybrielle James, James O. Peabody, Ahmed A. Hussein, and Khurshid A. Guru Ahmed S. ElsayedAhmed S. Elsayed More articles by this author , Yousuf RamahiYousuf Ramahi More articles by this author , Ayat A. ShahAyat A. Shah More articles by this author , Hannah B. ElyHannah B. Ely More articles by this author , Zhe JingZhe Jing More articles by this author , Holly HouensteinHolly Houenstein More articles by this author , Julian JosephJulian Joseph More articles by this author , Sharifeh AlmasaidSharifeh Almasaid More articles by this author , Gaybrielle JamesGaybrielle James More articles by this author , James O. PeabodyJames O. Peabody More articles by this author , Ahmed A. HusseinAhmed A. Hussein More articles by this author , and Khurshid A. GuruKhurshid A. Guru More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002544.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We sought to report the oncologic and functional outcomes of endopelvic fascia (EPF), puboprostatic ligament (PPL), and dorsal venous complex (DVC) preservation with hydrodissection of the neurovascular bundles (NVB) during robot-assisted radical prostatectomy (RARP). METHODS: A retrospective review of our prostate cancer database was performed. Patients who underwent either bilateral or unilateral nerve sparing-RARP were identified. Propensity score matching was performed between new surgical technique (Group 1) and a historical group (Group 2). Data was reviewed for perioperative, oncologic and functional outcomes. Kaplan Meier curves were used to depict biochemical recurrence-free survival (BRFS). Cumulative incidence curves were used to depict perfect continence (0 pads), social continence (0-1 pad) and potency (SHIM ≥17). Multivariate analyses (MVA) were used to depict variables associated with continence and potency. RESULTS: 202 patients were included in the study (76 in Group 1 and 126 in Group 2) with a median follow up of 17 months. Kaplan Meier curves showed similar BRFS (p=0.98). Group 1 showed higher perfect continence rates at 1 months (9% vs 3%), 3 months (24% vs 19%), and 6 months (54% vs 34%) compared to Group 2. Group 1 showed higher social continence rates at 1 month (15% vs 3%), 3 months (67% vs 32%), and 6 months (87% vs 53%) compared to Group 2 (Figure 1a-c). MVA showed that Group 1 was associated with perfect (HR 1.82, 95%CI 1.29–2.58, p<0.01) and social continence (HR 2.54, 95%CI 1.83 – 3.52, p<0.01), but not potency (Table 1). CONCLUSIONS: EPF, PPL, and DVC preservation with hydrodissection of the NVB offered similar oncological outcomes, but earlier and improved urinary continence rates compared to standard dissection. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e247 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ahmed S. Elsayed More articles by this author Yousuf Ramahi More articles by this author Ayat A. Shah More articles by this author Hannah B. Ely More articles by this author Zhe Jing More articles by this author Holly Houenstein More articles by this author Julian Joseph More articles by this author Sharifeh Almasaid More articles by this author Gaybrielle James More articles by this author James O. Peabody More articles by this author Ahmed A. Hussein More articles by this author Khurshid A. Guru More articles by this author Expand All Advertisement PDF DownloadLoading ...