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Retzius-sparing vs. posterior urethral suspension: similar early-phase post-robotic radical prostatectomy continence outcomes

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Abstract

Stress urinary incontinence (SUI) is a risk of robotic-assisted radical prostatectomy (RP) which can be a frustrating problem for both surgeons and patients. We aim to compare short-term continence outcomes between patients undergoing Retzius Sparing RP (RS-RP) and those undergoing standard RP with the inclusion of a PUS suture technique and suprapubic tube (PUS-RP). A retrospective review of 105 consecutive patients who underwent RP was performed, comparing patients who underwent RS-RP and PUS-RP. Our main outcome was pad usage as a surrogate for SUI. Patients were evaluated 4 weeks following RP and again at approximately 3 months. Continence was defined as no pad usage or up to one safety pad per day. Risk factors associated with not being continent were identified using univariate and multivariate analyses. In our cohort, 52 patients underwent RS-RP and 53 patients underwent PUS-RP. The two groups had similar patient demographics. Although not statistically significant, there was a higher rate of a positive surgical margin in the RS-RP compared to PUS-RP (25% vs 15%, p = 0.204). At one month follow-up for PUS-RP and RS-RP, there was no significant difference in the frequency of continent men (69.2% vs. 76.9%, p = 0.302). At 3-month follow-up for the two groups of patients, again, there was no significant difference in the frequency of continence for PUS-RP and RS-RP (86.2% vs 88%, p = 0.824). Patients who underwent RS-RP had similar rates of continence to those patients undergoing PUS-RP in the short-term post-operative period.

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data availability

The data that support the findings of this study are available on request from the corresponding author (JAC).

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Funding

Institutional funding within the Department of Urology.

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Authors and Affiliations

  1. Department of Urology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, USA

    Hal D. Kominsky, Mohannad A. Awad, Jacques Farhi, Jeffrey C. Gahan & Jeffrey A. Cadeddu

  2. Department of Surgery, King Abdulaziz University, Rabigh, Saudi Arabia

    Mohannad A. Awad

Authors
  1. Hal D. Kominsky
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  2. Mohannad A. Awad
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  3. Jacques Farhi
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  4. Jeffrey C. Gahan
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  5. Jeffrey A. Cadeddu
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Contributions

HDK JAC and JCG were responsible for study design, data analysis and manuscript preparation. MAA and JF were responsible for data analysis and manuscript preperation.

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Correspondence to Jeffrey A. Cadeddu.

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Kominsky, H.D., Awad, M.A., Farhi, J. et al. Retzius-sparing vs. posterior urethral suspension: similar early-phase post-robotic radical prostatectomy continence outcomes. J Robotic Surg 18, 64 (2024). https://doi.org/10.1007/s11701-023-01754-0

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  • DOI: https://doi.org/10.1007/s11701-023-01754-0

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