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. 2023 Aug;42(6):1411-1420.
doi: 10.1002/nau.25193. Epub 2023 Apr 25.

Comparison of postoperative urinary continence and incontinence types between conventional and Retzius-sparing robot-assisted radical prostatectomy

Yoshifumi Kadono  1 , Takahiro Nohara  1 , Shohei Kawaguchi  1 , Tomoyuki Makino  1 , Renato Naito  1 , Suguru Kadomoto  1 , Hiroaki Iwamoto  1 , Hiroshi Yaegashi  1 , Kazuyoshi Shigehara  1 , Kouji Izumi  1 , Atsushi Mizokami  1
Affiliations

Comparison of postoperative urinary continence and incontinence types between conventional and Retzius-sparing robot-assisted radical prostatectomy

Yoshifumi Kadono et al. Neurourol Urodyn. 2023 Aug.

Abstract

Aims: This study aimed to investigate the postoperative urinary continence rate and incontinence types compared over time between conventional robot-assisted radical prostatectomy (C-RARP) and Retzius-sparing RARP (RS-RARP).

Methods: All 61 cases were selected from the C-RARP and RS-RARP by propensity score matching, and the pad scale, 24-h pad weight test, and International consultation on incontinence questionnaire-short form (ICIQ-SF) were followed-up over time up to 12 months.

Results: The probability of urinary continence per pad scale evaluation differed according to how it was defined: the continence rate 12 months after C-RARP and RS-RARP were 94% and 95% for 1 pad/day, 85% and 92% for 1 security pad/day, 61% and 85% for no pad use, respectively, which were all significantly better with RS-RARP. The results of the 24-h pad weight test were significantly better with RS-RARP at both 3 and 12 months, with median C-RARP versus RS-RARP values of 5 versus 1 g and 2 versus 0 g, respectively. In terms of types of urinary incontinence, the rates of postoperative stress urinary incontinence (SUI) increased in both procedures but to a lesser extent in RS-RARP. Other types of urinary incontinence, such as urge incontinence and terminal dribbling, did not differ significantly before and after surgery and between the two procedures.

Conclusions: Postoperative urinary continence was better with RS-RARP than with C-RARP per all follow-up parameters until 12 months postoperatively. Postoperative SUI was significantly lower with RS-RARP than with C-RARP, which was considered the main reason for better postoperative urinary continence with RS-RARP.

Keywords: 24-h pad weight test; ICIQ-SF; Retzius-sparing; incontinence type; pad scale; robot-assisted radical prostatectomy; urinary incontinence.

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References

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