EARLY CONTINENCE RECOVERY AFTER ROBOT-ASSISTED RADICAL PROSTATECTOMY

摘要

Background. Urinary incontinence after radical prostatectomy bothers patients and leads to a deterioration in quality of life. Continence is the most important functional outcome of treatment of patients with prostate cancer. Objective. To evaluate the effectiveness of pelvic anatomy preservation for early continence recovery. Design and methods. We investigated 142 patients who underwent robot-assisted radical prostatectomy (RARP) in 2011-2015. Patients were divided into 3 groups: nerve-sparing RARP (N-RARP, n=44), nerve-sparing RARP with preservation of pelvic fascia, pubo-prostatic ligaments and pubo-perineal muscles (RARP-A, n=64) and RARP with preservation of the anatomical structures of the pelvis without preservation of the neurovascular bundles (RARP-B, n=34). Results . Groups did not differ in operation time (p=0.17), blood loss (p=0.77), intraoperative (p>0.1) and postoperative complications (p=0.64). Immediately after catheter removal and 1 month after surgery 53.9 %, 79.7 %, 54.6 % (p=0.012) and 61.4 %, 87,5 %, 84,6 % (p=0.005) of patients were continent in groups N-RARP, RARP-A and RARP-B, respectively. Correlation was found between the preserving of pelvic anatomical and continence recovery immediately after catheter removal (p=0.019) and at 1 month after surgery (p=0.001). Conclusion. Careful preservation of the pelvic anatomy leads to an early continence after RARP.