PD15-04 A RANDOMIZED CONTROLLED TRIAL EXAMINING THE IMPACT OF THE RETZIUS- SPARING APPROACH ON EARLY URINARY CONTINENCE RECOVERY AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy II1 Apr 2017PD15-04 A RANDOMIZED CONTROLLED TRIAL EXAMINING THE IMPACT OF THE RETZIUS- SPARING APPROACH ON EARLY URINARY CONTINENCE RECOVERY AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY Deepansh Dalela, Wooju Jeong, Madhu Ashni-Prasad, Akshay Sood, Firas Abdollah, Patrick Karabon, Mireya Diaz, Sriram Eleswarapu, Jesse Sammon, Brad Baize, Andrea Simone, and Mani Menon Deepansh DalelaDeepansh Dalela More articles by this author , Wooju JeongWooju Jeong More articles by this author , Madhu Ashni-PrasadMadhu Ashni-Prasad More articles by this author , Akshay SoodAkshay Sood More articles by this author , Firas AbdollahFiras Abdollah More articles by this author , Patrick KarabonPatrick Karabon More articles by this author , Mireya DiazMireya Diaz More articles by this author , Sriram EleswarapuSriram Eleswarapu More articles by this author , Jesse SammonJesse Sammon More articles by this author , Brad BaizeBrad Baize More articles by this author , Andrea SimoneAndrea Simone More articles by this author , and Mani MenonMani Menon More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.3286AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Retzius-sparing (posterior) robot-assisted radical prostatectomy (RARP) may expedite urinary continence (UC) recovery. We compared the short-term (≤3 months) UC, urinary function (UF) and UF-related bother outcomes of posterior RARP compared to standard approach (anterior) RARP in a randomized controlled trial (RCT). METHODS 120 patients aged 40-75 with low-intermediate risk prostate cancer (PCa) undergoing primary RARP by a single surgeon were randomized 1:1 to posterior (n=60) or anterior RARP (n=60). Primary outcome was UC (defined as 0 pad/one security liner per day and verified using 24-hour pad weights) 1 week after catheter removal. Secondary outcomes were time to UC recovery, UF and UF-related bother scores (measured by the International Prostatic Symptom Score (IPSS) and IPSS-Quality-of-Life scores respectively) assessed at 1 week, 2 weeks, 1 and 3 months following catheter removal. UC recovery was analyzed using Kaplan-Meier method and Cox proportional hazards regression. Linear generalized estimating equations (GEE) were used to compare UF and UF-related bother scores. RESULTS Median age of the cohort was 61 years. 75.8% harbored intermediate-risk PCa. 71.2% in the posterior vs. 48.3% in the anterior arm were continent 1-week post-catheter removal (p=0.01); corresponding median 24-hour pad weights were 5 and 25 gm respectively (p=0.001). Posterior RARP showed faster UC recovery (figure 1); 94.9% in posterior vs. 85.8% in anterior RARP arms were continent at 3 months (p=0.018), and findings were confirmed on multivariable regression analyses. Urinary bother scores were significantly lower in the posterior vs. anterior RARP group at 1,2 and 4 weeks on GEE analyses (figure 2). CONCLUSIONS This single-center RCT shows that in the hands of an experienced surgeon, Retzius-sparing approach of RARP resulted in earlier recovery of UC and lower UF-related bother than standard RARP in patients with low-intermediate risk PCa © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e283-e284 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Deepansh Dalela More articles by this author Wooju Jeong More articles by this author Madhu Ashni-Prasad More articles by this author Akshay Sood More articles by this author Firas Abdollah More articles by this author Patrick Karabon More articles by this author Mireya Diaz More articles by this author Sriram Eleswarapu More articles by this author Jesse Sammon More articles by this author Brad Baize More articles by this author Andrea Simone More articles by this author Mani Menon More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...