The powerful impact of double-layered posterior rhabdosphincter reconstruction on early recovery of urinary continence after robot-assisted radical prostatectomy

Tatsuo Gondo, Kunihiko Yoshioka, Takeshi Hashimoto, Yoshihiro Nakagami, Riu Hamada, Takeshi Kashima, Kenji Shimodaira, Hisashi Takeuchi, Naoya Satake, Masaaki Tachibana, Bernardo Rocco

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background and Purpose: The usefulness of posterior rhabdosphincter reconstruction (PR) during robot-assisted radical prostatectomy (RARP) has still been controversial. We investigated the association of several factors, including the Rocco original double-layered PR, with early recovery of urinary continence after RARP. Patients and Methods: Between August 2006 and April 2011, a single surgeon at Tokyo Medical University Hospital performed 206 RARPs. Of these 206 patients, 199 eligible patients were enrolled in this study. We retrospectively analyzed the correlation of several perioperative factors, including surgical techniques, with early recovery of urinary continence 1 month after catheter removal. Continence was defined as no use or the use of only one safety pad. Results: Univariate analysis showed that surgeon experience, lateral approach of bladder neck preservation, bladder neck reconstruction, anterior reconstruction, and the Rocco double-layered PR were significantly associated with early recovery of urinary continence 1 month after catheter removal. Preoperative prostate-specific antigen level, body mass index, and attempted nerve-sparing (NS) procedures, however, were not significantly associated with early recovery of urinary continence. Multivariate logistic regression analysis showed that the Rocco PR and attempted NS were the only independent predictive factors of urinary continence recovery 1 month after catheter removal (odds ratio [OR], 15.01; 95% confidence interval [CI], 3.413-66.67; P=0.0003 and OR, 2.248; 95% CI, 1.048-4.975; P=0.0402, respectively). When we applied NS as well as the Rocco PR, the recovery rates of continence at 1 month after catheter removal was 85.3%. Conclusions: The Rocco double-layered PR and attempted NS and not surgeon experience were the significant independent predictive factors of early recovery of urinary continence after RARP. NS procedures positively influenced early recovery of urinary continence only when they were applied with the PR technique.

Original languageEnglish
Pages (from-to)1159-1164
Number of pages6
JournalJournal of Endourology
Volume26
Issue number9
DOIs
Publication statusPublished - Sep 1 2012

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Prostatectomy
Catheters
Urinary Bladder
Odds Ratio
Confidence Intervals
Tokyo
Prostate-Specific Antigen
Body Mass Index
Logistic Models
Regression Analysis
Safety
Surgeons

ASJC Scopus subject areas

  • Urology

Cite this

The powerful impact of double-layered posterior rhabdosphincter reconstruction on early recovery of urinary continence after robot-assisted radical prostatectomy. / Gondo, Tatsuo; Yoshioka, Kunihiko; Hashimoto, Takeshi; Nakagami, Yoshihiro; Hamada, Riu; Kashima, Takeshi; Shimodaira, Kenji; Takeuchi, Hisashi; Satake, Naoya; Tachibana, Masaaki; Rocco, Bernardo.

In: Journal of Endourology, Vol. 26, No. 9, 01.09.2012, p. 1159-1164.

Research output: Contribution to journalArticle

Gondo, T, Yoshioka, K, Hashimoto, T, Nakagami, Y, Hamada, R, Kashima, T, Shimodaira, K, Takeuchi, H, Satake, N, Tachibana, M & Rocco, B 2012, 'The powerful impact of double-layered posterior rhabdosphincter reconstruction on early recovery of urinary continence after robot-assisted radical prostatectomy', Journal of Endourology, vol. 26, no. 9, pp. 1159-1164. https://doi.org/10.1089/end.2012.0067
Gondo, Tatsuo ; Yoshioka, Kunihiko ; Hashimoto, Takeshi ; Nakagami, Yoshihiro ; Hamada, Riu ; Kashima, Takeshi ; Shimodaira, Kenji ; Takeuchi, Hisashi ; Satake, Naoya ; Tachibana, Masaaki ; Rocco, Bernardo. / The powerful impact of double-layered posterior rhabdosphincter reconstruction on early recovery of urinary continence after robot-assisted radical prostatectomy. In: Journal of Endourology. 2012 ; Vol. 26, No. 9. pp. 1159-1164.
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AU - Hamada, Riu

AU - Kashima, Takeshi

AU - Shimodaira, Kenji

AU - Takeuchi, Hisashi

AU - Satake, Naoya

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