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Review
. 2024 Dec;12(4):179-185.
doi: 10.1016/j.prnil.2024.04.004. Epub 2024 Apr 29.

Effects of bladder neck sparing on continence outcomes of robotic-assisted radical prostatectomy: a systemic review and metaanalysis

Joongwon Choi  1 , Yun-Jung Yang  2 , Chung Un Lee  1 , Jung Hoon Kim  1 , Jin Wook Kim  1 , Jong Hyun Tae  3 , Se Young Choi  3 , In Ho Chang  3 , Eun-Jung Yang  4 , Yong Seong Lee  1
Affiliations
Review

Effects of bladder neck sparing on continence outcomes of robotic-assisted radical prostatectomy: a systemic review and metaanalysis

Joongwon Choi et al. Prostate Int. 2024 Dec.

Abstract

Restoration of postoperative urinary continence after robot-assisted radical prostatectomy (RARP) is affected by diverse factors. We compared the pad-free and positive margin rates of patients who underwent RARP with or without bladder neck sparing (BNS) for prostate cancer. During this systematic review and metaanalysis, we performed an electronic search of the Web of Science, Embase, Cochrane Central Register of Controlled Trials, and PubMed to find original articles comparing RARP with and without BNS for prostate cancer. We identified six studies (2,351 patients in total) who underwent RARP with or without BNS. A metaanalysis of the pad-free rate at 3 months was performed. The overall pad-free rate at 3 months for patients who underwent RARP with BNS was significantly higher than that of patients who underwent RARP alone (control group) (odds ratio, 1.86; 95% confidence interval [CI], 1.22-2.82), with high heterogeneity (P = 0.005; I2 = 67.45%). The pad-free rates at 7 days, 6 months, and 1 year and positive surgical margin rates of patients who underwent BNS were not significantly different than those in the control group. Although no statistical difference was observed, the catheterization period of the BNS group was shorter than that of the control group (standardized mean difference = -0.08; 95% CI, -0.16 to 0.01). Although RARP with BNS did not affect the long-term outcome of continence, it had a significant effect on the early recovery of continence.

Keywords: Metaanalysis; Prostatectomy; Robotics; Urinary incontinence.

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Conflict of interest statement

All authors have no potential conflicts of interest.

Figures

Fig. 1
Fig. 1
Flowchart of the study selection procedure.
Fig. 2
Fig. 2
Comparison of robot field of view between (A) bladder neck sparing and (B) without bladder neck sparing techniques.
Fig. 3
Fig. 3
A random effects model was used to create the (A) forest plot and (B) funnel plot comparing the pad-free rates of patients who underwent bladder neck sparing (BNS) and the control group at 3 months.
See this image and copyright information in PMC

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