MP61-06 IMPACT OF POSTERIOR RECONSTRUCTION URETHROVESICAL ANASTOMOSIS ON 5-YEAR INCIDENCE OF UNDERGOING CONTINENCE IMPROVING PROCEDURES AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY: A RANDOMIZED CONTROLLED TRIAL

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP61-06 IMPACT OF POSTERIOR RECONSTRUCTION URETHROVESICAL ANASTOMOSIS ON 5-YEAR INCIDENCE OF UNDERGOING CONTINENCE IMPROVING PROCEDURES AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY: A RANDOMIZED CONTROLLED TRIAL Braden Millan, Jen Hoogenes, Michael Uy, Raees Cassim, and Bobby Shayegan Braden MillanBraden Millan More articles by this author , Jen HoogenesJen Hoogenes More articles by this author , Michael UyMichael Uy More articles by this author , Raees CassimRaees Cassim More articles by this author , and Bobby ShayeganBobby Shayegan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003319.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Posterior reconstruction of the Denonvilliers’ musculofascial plate also known as the Rocco stitch, have shown mixed results on early return to urinary continence, yet little data exist on long-term outcomes. The objective of this study was to evaluate the long-term need for incontinence improving procedures post robot-assisted radical prostatectomy (RARP) comparing posterior reconstruction urethrovesical anastomosis (PR-UVA) versus conventional urethrovesical anastomosis (C-UVA). METHODS: Consecutive patients with clinically localized prostate cancer undergoing RARP were randomized to PR-UVA or C-UVA groups. Return to continence outcomes were assessed using a validated questionnaire (Expanded Prostate Cancer Index Composite [EPIC] Short Form-26) at baseline, 2, 3, 4, 6, 8, and 12-month follow-up. Five-year outcomes were assessed by frequency of continence-improving procedures. RESULTS: A total of 163 patients were randomized from April 2014 to July 2015 and 140 patients completed follow-up. Pre-operative clinical and functional variables were equivalent between study arms. Using a continence definition of 0-1 pads/day, the continence rates for PR-UVA versus the C-UVA were 39% versus 38% at 2 months (p=1.0), and 93% versus 86%, respectively, at 12 months (p=0.3). Frequency of urine leak, quantity of pad use, subjective urinary control, and overall bother improved significantly in all patients during the 12-month study period (p<0.001); however, no difference was demonstrated between groups. Five-year results showed no difference in the number of patients undergoing a continence-improving procedure (HR 0.90, 95% CI 0.29-2.80; p=0.09). CONCLUSIONS: PR-UVA failed to show a benefit in short-term return to urinary continence or need for an incontinence improving procedure at 5-year follow-up post RARP. Source of Funding: The Masonic Foundation of Ontario © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e854 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Braden Millan More articles by this author Jen Hoogenes More articles by this author Michael Uy More articles by this author Raees Cassim More articles by this author Bobby Shayegan More articles by this author Expand All Advertisement PDF downloadLoading ...