V12-05 Anterior Suspension of Posterior Reconstruction by Medial Umbilical Fold—a Novel Technique to Improve Immediate Continence Following Robot-Assisted Radical Prostatectomy

You have accessJournal of UrologyProstate Oncology/Penile & Testis Oncology/Misc. Oncology II (V12)1 May 2024V12-05 ANTERIOR SUSPENSION OF POSTERIOR RECONSTRUCTION BY MEDIAL UMBILICAL FOLD—A NOVEL TECHNIQUE TO IMPROVE IMMEDIATE CONTINENCE FOLLOWING ROBOT-ASSISTED RADICAL PROSTATECTOMY Chaohui Gu, Yongbo Luo, Yuanhao Liu, Yiheng Dai, Donghui Jia, Lijie Zhou, and Xuepei Zhang Chaohui GuChaohui Gu , Yongbo LuoYongbo Luo , Yuanhao LiuYuanhao Liu , Yiheng DaiYiheng Dai , Donghui JiaDonghui Jia , Lijie ZhouLijie Zhou , and Xuepei ZhangXuepei Zhang View All Author Informationhttps://doi.org/10.1097/01.JU.0001009480.90141.21.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Except for traditional techniques such as preservation of neurovascular bundles, pubovesical complex, detrusor apron, and Rocco sutures suspension, and bilateral umbilical vascular ligament suspension, there is still a need to explore novel approaches to improve postoperative continence rates in robotic-assisted radical prostatectomy (RARP). This video describes our new technique of anterior suspension of posterior reconstruction by medial umbilical fold (ASPRMUF) following RARP. We compare continence rates in patients who underwent ASPRMUF versus those with only posterior reconstruction (PRS) and explore the efficacy and safety of ASPRMUF. METHODS: After institutional ethics committee approval, a retrospective analysis was conducted. The ASPRMUF group included 24 patients treated between Apr. 2023 and Jul. 2023, while the PRS group included 23 patients treated between Oct. 2020 and Mar. 2023. In brief technique include: 1. Dissection of medial umbilical fold; 2. Before urethrovesical anastomosis, suturing the medial umbilical fold to the posterior urethra; 3. Anterior suspension of urethrovesical anastomosis after urethrovesical anastomosis. Immediate continence or early continence was defined as usage of 0-1 pad for safety per 24 hours 2-7 days or 1 and 3 months after the surgery. RESULTS: There were no significant differences in recognized variables that affect continence following a prostatectomy such as age, body mass index, prostate weight and clinical T stage in two groups. In addition, surgical operation time, positive surgical margin rate and complication (lymphorrhagia) rate have no significant differences. The immediate continence and early continence rates at 1 and 3 months (91.7% vs 9%, p<0.0001; 100% vs 22%, p<0.0001; 100% vs 44%, p=0.007) were markedly higher in ASPRMUF group. The catheterization time (3.7±1.8 vs 7.0±0.0 d, p<0.0001) and postoperative length of stay (5.8±0.8 vs 11.5±3.4 d, p<0.0001) were shorter in ASPRMUF group. There are no complications related to pubic suspension of medial umbilical fold including necrosis, infection and urinary retention et al. CONCLUSIONS: The anterior suspension of posterior reconstruction by medial umbilical fold had better immediate and early continence recovery with less challenging and no complications were found. This technique provides a more precise suspension effect than bilateral umbilical vascular ligament suspension, which serves as an effective strategy to improve postoperative continence. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e996 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Chaohui Gu More articles by this author Yongbo Luo More articles by this author Yuanhao Liu More articles by this author Yiheng Dai More articles by this author Donghui Jia More articles by this author Lijie Zhou More articles by this author Xuepei Zhang More articles by this author Expand All Advertisement PDF downloadLoading ...