Skip to main content

Advertisement

SpringerLink
Log in

Vas deferens urethral support improves early post-prostatectomy urine continence

  • Original Article
  • Published:
Journal of Robotic Surgery Aims and scope Submit manuscript

Abstract

Urine continence is often impaired after radical prostatectomy. Few randomized studies prove the efficacy of novel surgical approaches. Vas deferens urethral support (VDUS) during robot-assisted laparoscopic prostatectomy (RALP) was studied for improvement of early postoperative urine continence in a single-centre prospective double-blind randomized study with a power of 90% to detect a 30% decrease in early incontinence. 112 men were randomized, and 108 could be analyzed (VDUS n = 54, noVDUS n = 54). VDUS improved early continence by 40% at 1 month (59% vs. 35%, P = 0.02); 6 months postoperatively this was 72% vs. 62%, P = 0.41. A 24-h pad test at 1 day, 3 days, and 1 week showed decreased amounts of urine loss in the VDUS group. The ICIQ-SF score was significantly lower for the VDUS group within the first month after surgery. VDUS had no impact upon quality of life questionnaire analyses for overall and lower urinary tract symptom-related quality of life but showed a significant improvement in the social domain of the EORTC-QLQ-C30 questionnaire. VDUS moderately improved early urine continence within 1 month after RALP.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

EORTC:

European Organization for Research and Treatment of Cancer

FP-score:

Fascia preservation score

ICIQ-SF:

International Consultation on Incontinence questionnaire—short form

IIEF:

International Index of Erectile Function

LUTS:

Lower urinary tract symptom score

QOL:

Quality of life

RALP:

Robot-assisted laparoscopic prostatectomy

VDUS:

Vas deferens urethral support

References

  1. Coelho RF, Rocco B, Patel MB et al (2010) Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a critical review of outcomes reported by high-volume centers. J Endourol 24:2003–2015

    Article  PubMed  Google Scholar 

  2. Burkhard FC, Kessler TM, Fleischmann A, Thalmann GN, Schumacher M, Studer UE (2006) Nerve sparing open radical retropubic prostatectomy – does it have an impact on urinary continence? J Urol 176:189–195

    Article  PubMed  Google Scholar 

  3. van der Poel HG, de Blok W, Joshi N, van Muilekom E (2009) Preservation of lateral prostatic fascia is associated with urine continence after robotic-assisted prostatectomy. Eur Urol 55:892–900

    Article  PubMed  Google Scholar 

  4. Wille S, Varga Z, Von Knobloch R, Hofmann R (2005) Intussusception of bladder neck improves early continence after radical prostatectomy: results of a prospective trial. Urology 65:524–527

    Article  PubMed  CAS  Google Scholar 

  5. Selli C, De Antoni P, Moro U, Macchiarella A, Giannarini G, Crisci A (2004) Role of bladder neck preservation in urinary continence following radical retropubic prostatectomy. Scand J Urol Nephrol 38:32–37

    Article  PubMed  Google Scholar 

  6. Walsh PC, Marschke PL (2002) Intussusception of the reconstructed bladder neck leads to earlier continence after radical prostatectomy. Urology 59:934–938

    Article  PubMed  Google Scholar 

  7. Walz J, Burnett AL, Costello AJ et al (2010) A critical analysis of the current knowledge of surgical anatomy related to optimization of cancer control and preservation of continence and erection in candidates for radical prostatectomy. Eur Urol 57:179–192

    Article  PubMed  Google Scholar 

  8. Rocco F, Carmignani L, Acquati P et al (2007) Early continence recovery after open radical prostatectomy with restoration of the posterior aspect of the rhabdosphincter. Eur Urol 52:376–383

    Article  PubMed  Google Scholar 

  9. Coelho RF, Chauhan S, Orvieto MA, Sivaraman A, Palmer KJ, Coughlin G, Patel VR (2011) Influence of modified posterior reconstruction of the rhabdosphincter on early recovery of continence and anastomotic leakage rates after robot-assisted radical prostatectomy. Eur Urol 59:72-80. doi:10.1016/j.eururo.2010.08.025

    Google Scholar 

  10. Joshi N, de Blok W, van Muilekom E, van der Poel H (2010) Impact of posterior musculofascial reconstruction on early continence after robot-assisted laparoscopic radical prostatectomy: results of a prospective parallel group trial. Eur Urol 58:84–89

    Article  PubMed  Google Scholar 

  11. Patel VR, Coelho RF, Palmer KJ, Rocco B (2009) Periurethral suspension stitch during robot-assisted laparoscopic radical prostatectomy: description of the technique and continence outcomes. Eur Urol 56:472–478

    Article  PubMed  Google Scholar 

  12. Van Velthoven RF, Ahlering TE, Peltier A, Skarecky DW, Clayman RV (2003) Technique for laparoscopic running urethrovesical anastomosis: the single knot method. Urology 61:699–702

    Article  PubMed  Google Scholar 

  13. Menon M, Muhletaler F, Campos M, Peabody JO (2008) Assessment of early continence after reconstruction of the periprostatic tissues in patients undergoing computer assisted (robotic) prostatectomy: results of a 2 group parallel randomized controlled trial. J Urol 180:1018–1023

    Article  PubMed  Google Scholar 

  14. Noguchi M, Kakuma T, Suekane S, Nakashima O, Mohamed ER, Matsuoka K (2008) A randomized clinical trial of suspension technique for improving early recovery of urinary continence after radical retropubic prostatectomy. BJU Int 102:958–963

    Article  PubMed  Google Scholar 

  15. Rocco B, Gregori A, Stener S et al (2007) Posterior reconstruction of the rhabdosphincter allows a rapid recovery of continence after transperitoneal videolaparoscopic radical prostatectomy. Eur Urol 51:996–1003

    Article  PubMed  Google Scholar 

  16. Gautam G, Rocco B, Patel VR, Zorn KC (2010) Posterior rhabdosphincter reconstruction during robot-assisted radical prostatectomy: critical analysis of techniques and outcomes. Urology 76:734–741

    Article  PubMed  Google Scholar 

  17. van der Poel HG, de Blok W (2009) Role of extent of fascia preservation and erectile function after robot-assisted laparoscopic prostatectomy. Urology 73:816–821

    Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Urology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    H. G. van der Poel, W. De Blok & H. A. M. Van Muilekom

Authors
  1. H. G. van der Poel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. W. De Blok
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. A. M. Van Muilekom
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to H. G. van der Poel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

van der Poel, H.G., De Blok, W. & Van Muilekom, H.A.M. Vas deferens urethral support improves early post-prostatectomy urine continence. J Robotic Surg 6, 289–294 (2012). https://doi.org/10.1007/s11701-011-0309-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11701-011-0309-0

Keywords

Search

Navigation