V12-11 THE EFFECT OF VESICOPEXY ON URINARY CONTINENCE RECOVERY FOLLOWING ROBOTIC-ASSISTED RADICAL PROSTATECTOMY: TECHNIQUE AND OUTCOMES

Abstract

You have accessJournal of UrologyProstate Oncology I (Prostatectomy) (V12)1 Sep 2021V12-11 THE EFFECT OF VESICOPEXY ON URINARY CONTINENCE RECOVERY FOLLOWING ROBOTIC-ASSISTED RADICAL PROSTATECTOMY: TECHNIQUE AND OUTCOMES Alireza Ghoreifi, Wesley Yip, Kian Asanad, Marissa Maas, Guadalupe Gonzalez, Jamal Nabhani, and Hooman Djaladat Alireza GhoreifiAlireza Ghoreifi More articles by this author , Wesley YipWesley Yip More articles by this author , Kian AsanadKian Asanad More articles by this author , Marissa MaasMarissa Maas More articles by this author , Guadalupe GonzalezGuadalupe Gonzalez More articles by this author , Jamal NabhaniJamal Nabhani More articles by this author , and Hooman DjaladatHooman Djaladat More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002093.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urinary incontinence (UI) is a challenging issue in patients undergoing robotic-assisted radical prostatectomy (RARP). Multiple techniques that aim to restore normal lower urinary tract anatomy have been proposed to improve postoperative continence. The aim of this video is to present a new technique of vesicopexy and its effect on early postoperative urinary continence recovery in patients undergoing RARP with an anterior approach. METHODS: In this technique, following the completion of the urethrovesical anastomosis, the bladder is fixed to the anterior abdominal wall using a 2-0 V-Loc™ barbed suture. Pelvic floor exercises using Kegel technique were recommended to all patients following catheter removal. Urinary continence was assessed using a pictorial pad usage questionnaire at 1 and 3 months postoperatively. Continence was defined as no or only safety pad usage. The illustrative case in the video is a 68-year-old male with prostate cancer, who underwent RARP with vesicopexy using the Da Vinci Xi robot platform. We also report the feasibility and outcomes of this technique in 60 consecutive patients who underwent RARP and vesicopexy between March 2019 and December 2020. RESULTS: A total of 60 patients were included in the pilot study. The median age was 65 years, and median body mass index was 28. The median preoperative International Prostate Symptom Score was 10. 12 (20%) patients underwent a bladder neck reconstruction, and nerve sparing was performed unilaterally in 24 (40%) and bilaterally in 24 (40%) patients. Salvage surgery was performed in one patient following failed cryotherapy. The remainder of the baseline and clinical features of the patients are shown in Table 1. At 1- and 3-month follow-ups, continence rates were 52% and 85%, respectively. Postoperative complications were seen in 5 (8.3%) patients (3 urine leak, 1 pelvic abscess, and 1 urinary retention) that were managed medically/conservatively. CONCLUSIONS: Vesicopexy is a safe, feasible and simple technique that may lead to a satisfactory recovery of early continence in patients undergoing RARP with an anterior approach. The next step is to evaluate this technique through a randomized controlled trial. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1027-e1027 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alireza Ghoreifi More articles by this author Wesley Yip More articles by this author Kian Asanad More articles by this author Marissa Maas More articles by this author Guadalupe Gonzalez More articles by this author Jamal Nabhani More articles by this author Hooman Djaladat More articles by this author Expand All Advertisement Loading ...