Bladder neck plication stitch: a novel technique during robot-assisted radical prostatectomy to improve recovery of urinary continence.
Publication/Presentation Date
12-1-2011
Abstract
BACKGROUND AND PURPOSE: Efforts to improve postprostatectomy incontinence have led to many modifications in surgical technique. We present our experience with a novel technique to improve continence outcomes in patients who are undergoing robot-assisted radical prostatectomy (RARP).
PATIENTS AND METHODS: A consecutive series of 159 patients after initiation of a bladder neck plication stitch was compared with the most recent group before the change. After completion of the vesicourethral anastomosis, a single suture was used to plicate the distal bladder neck. A structured questionnaire was used for follow-up. Continence criteria used were 1 pad per day for social continence and 0 pad per day for total continence.
RESULTS: A total of 334 patients were included in the study: 159 in the plication stitch group vs 175 in the control group. Average age was 59.1 vs 59.6 years, average body mass index was 27.9 vs 28.3 kg/m(2), and average prostate volume was 58.1 vs 60.9 cc, respectively. The mean time to reach social continence was 3.63±3.01 vs 5.33±4.89 weeks (P=0.004), and total continence was 5.10±3.80 vs 8.49±6.32 weeks (P=0.002), respectively. Chance of total continence improved with the bladder plication stitch: Odds ratio of 1.95±0.72 (P< 0.001) at 1 month, 1.25±0.56 (P=0.113) at 3 months, and 2.07±0.66 (P=0.005) at 12 months. There were no bladder neck contractures or other urinary complications noted in either group.
CONCLUSIONS: The bladder plication stitch is a simple and effective technical modification for shortening the period of recovery of urinary continence in RARP patients. Randomized controlled trials are under way to further evaluate this technique.
Volume
25
Issue
12
First Page
1873
Last Page
1877
ISSN
1557-900X
Published In/Presented At
Lee, D. I., Wedmid, A., Mendoza, P., Sharma, S., Walicki, M., Hastings, R., Monahan, K., & Eun, D. (2011). Bladder neck plication stitch: a novel technique during robot-assisted radical prostatectomy to improve recovery of urinary continence. Journal of endourology, 25(12), 1873–1877. https://doi.org/10.1089/end.2011.0279
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
21942755
Department(s)
Administration and Leadership
Document Type
Article