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Vesicoprostatic muscle reconstruction: a step further for immediate and early urinary continence

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World Journal of Urology Aims and scope Submit manuscript

Abstract

Objectives

The vesicoprostatic muscle (VPM) is a longitudinal smooth muscle that originates from the trigone of the bladder or the opening of the ureter and is involved in urination as part of the detrusor apron. We explored the effect of VPM reconstruction on immediate and early recovery of urinary continence in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALP).

Patients and methods

A total of 523 patients with localized prostate cancer were enrolled from June 2018 to June 2020. All patients were diagnosed in our department based on magnetic resonance imaging and pathological findings on prostate biopsy. After 1:1 propensity score matching, 105 patient pairs were matched. The study was approved by our institutional review board and all surgeries were performed by three experienced high-volume surgeons. Demographic data, total operation time, pathological outcomes, the urinary continence rates of the two groups at different times after RALP, and factors influencing postoperative urinary continence after RALP were recorded. Student’s t test was used to compare continuous variables and the Pearson χ2 test to compare categorical variables. Logistic regression analysis was used to identify factors affecting immediate and early postoperative urinary control.

Results

VPM reconstruction promoted immediate and early recovery of urinary continence (immediate continence, 66.67 vs. 40.00%, P = 0.000; 3-month continence, 80.95 vs. 64.76%, P = 0.008).

Conclusions

VPM reconstruction improved immediate and early urinary continence in patients who underwent RALP.

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Data availability

All relevant data are within the manuscript and its Additional files.

Abbreviations

RALP:

Robot-assisted laparoscopic radical prostatectomy

VPM:

Vesicoprostatic muscle

EPIC:

The Expanded Prostate Cancer Index Composite urinary assessment

BMI:

Body mass index

DM:

Diabetes mellitus

PSM:

Positive surgical margin

NVB:

Neurovascular bundle

ARVUS:

Advanced reconstruction of vesicourethral support

TAR:

Total anatomical reconstruction

MULP:

Modified maximal urethral length preservation technique

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Funding

This work was financially supported by the project of construction of precision diagnosis and treatment technology system for prostate cancer in the elderly population at PLA General Hospital: 21BJZ27.

Author information

Author notes

  1. Yu Gao, Yang Yang, Xing Li, and Tao Wang are co-first authors.

Authors and Affiliations

  1. Department of Urology, The Third Medical Centre, Chinese PLA General Hospital, Beijing, People’s Republic of China

    Yu Gao, Yang Yang, Tao Wang, Qiang Cheng, Zhuo Jia, Shao-xi Niu, Xiang-yi Zhang, Bao-jun Wang & Xu Zhang

  2. Medical School of Chinese PLA, Beijing, People’s Republic of China

    Yang Yang & Tao Wang

  3. Department of Urology, China Rehabilitation Research Centre, Rehabilitation School of Capital Medical University, Beijing, People’s Republic of China

    Xing Li

  4. Department of Urology, PLA Military General Hospital, 28 Fuxing Road, Beijing, 100853, People’s Republic of China

    Bao-jun Wang & Xu Zhang

Authors
  1. Yu Gao
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  2. Yang Yang
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  3. Xing Li
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  4. Tao Wang
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  5. Qiang Cheng
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  6. Zhuo Jia
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  7. Shao-xi Niu
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  8. Xiang-yi Zhang
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  9. Bao-jun Wang
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  10. Xu Zhang
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Contributions

YG, XL, YY, TW, QC, and ZJ contributed to testing, statistical analysis, article writing, and editing. SN, XZ, BW, and XZ contributed to project design, article writing, and editing.

Corresponding authors

Correspondence to Bao-jun Wang or Xu Zhang.

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Conflict of interest

The authors declare that they have no conficts of interest.

Ethical approval

Our study was approved by the local ethics committee and performed in accordance with the ethical standards of the institutional research committee. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Gao, Y., Yang, Y., Li, X. et al. Vesicoprostatic muscle reconstruction: a step further for immediate and early urinary continence. World J Urol 41, 1511–1517 (2023). https://doi.org/10.1007/s00345-023-04398-9

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  • DOI: https://doi.org/10.1007/s00345-023-04398-9

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