Robotic Anastomoses and Bladder Neck Reconstruction Following Radical Prostatectomy

  • Marc C. SmaldoneEmail author
  • Tina K. Schuster
  • Stephen V. Jackman
Part of the Current Clinical Urology book series (CCU)


With the introduction of robotic-assisted technology, there has been a dramatic evolution of minimally invasive prostate cancer surgery. Rapidly gaining popularity in both the United States and abroad, advantages of the robotic platform include enhanced stereoscopic depth of field vision and dexterity facilitating precise suturing for reconstruction. In addition to the conventional benefits of laparoscopy including reduced blood loss and quicker convalescence, reported short-term and intermediate quality of life and oncologic outcomes are now comparable to that of the traditional open radical retropubic prostatectomy. With increasing experience, successful outcomes have been reported in patients with obesity, prior abdominal surgeries, pronounced median lobe, previous prostate surgery, and salvage cases following pelvic radiation. In this chapter, we review basic technique, discuss challenging anatomy with suggestions for technical modification, and discuss current oncologic and functional outcomes following robotic-assisted laparoscopic prostatectomy.


Prostatectomy Robotic assisted Minimally invasive Technique Outcomes 

Supplementary material

Robotic Vesicourethral Anastomosis and Bladder Neck Reconstruction Following Robot Assisted Radical Prostatectomy (49.1 MB)


  1. 1.
    Benjamin JA. Hugh Hampton Young 1870–1945. Science. 26 Oct 1945;102(2652):416–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Miller JA, Staunton MD. The birth of retropubic prostatectomy – Millin. J R Soc Med. Aug 1989;82(8):494–5.PubMedGoogle Scholar
  3. 3.
    Reiner WG, Walsh PC. An anatomical approach to the surgical management of the dorsal vein and Santorini’s plexus during radical retropubic surgery. J Urol. Feb 1979;121(2):198–200.PubMedGoogle Scholar
  4. 4.
    Lepor H, Gregerman M, Crosby R, Mostofi FK, Walsh PC. Precise localization of the autonomic nerves from the pelvic plexus to the corpora cavernosa: a detailed anatomical study of the adult male pelvis. J Urol. Feb 1985;133(2):207–12.PubMedGoogle Scholar
  5. 5.
    Litwin MS, Gore JL, Kwan L, et al. Quality of life after surgery, external beam irradiation, or brachytherapy for early-stage prostate cancer. Cancer. 1 Jun 2007;109(11):2239–47.PubMedCrossRefGoogle Scholar
  6. 6.
    Steineck G, Helgesen F, Adolfsson J, et al. Quality of life after radical prostatectomy or watchful waiting. N Engl J Med. 12 Sep 2002;347(11):790–6.PubMedCrossRefGoogle Scholar
  7. 7.
    Schuessler WW, Schulam PG, Clayman RV, Kavoussi LR. Laparoscopic radical prostatectomy: initial short-term experience. Urology. Dec 1997;50(6):854–7.PubMedCrossRefGoogle Scholar
  8. 8.
    Guillonneau B, Vallancien G. Laparoscopic radical prostatectomy: the Montsouris experience. J Urol. Feb 2000;163(2):418–22.PubMedCrossRefGoogle Scholar
  9. 9.
    Rassweiler J, Seemann O, Schulze M, Teber D, Hatzinger M, Frede T. Laparoscopic versus open radical prostatectomy: a comparative study at a single institution. J Urol. May 2003;169(5):1689–93.PubMedCrossRefGoogle Scholar
  10. 10.
    Abbou CC, Hoznek A, Salomon L, et al. Remote laparoscopic radical prostatectomy carried out with a robot report of a case. Prog Urol. Sep 2000;10(4):520–3.PubMedGoogle Scholar
  11. 11.
    Badani KK, Kaul S, Menon M. Evolution of robotic radical prostatectomy: assessment after 2766 procedures. Cancer. 1 Nov 2007;110(9):1951–8.PubMedCrossRefGoogle Scholar
  12. 12.
    D’Amico AV, Whittington R, Malkowicz SB, et al. Biochemical outcome after radical prostatectomy or external beam radiation therapy for patients with clinically localized prostate carcinoma in the prostate specific antigen era. Cancer. 15 Jul 2002;95(2):281–6.PubMedCrossRefGoogle Scholar
  13. 13.
    Daneshmand S, Quek ML, Stein JP, et al. Prognosis of patients with lymph node positive prostate cancer following radical prostatectomy: long-term results. J Urol. Dec 2004;172(6 Pt 1):2252–5.PubMedCrossRefGoogle Scholar
  14. 14.
    Kaouk JH, Hafron J, Goel R, Haber GP, Jones JS. Robotic salvage retropubic prostatectomy after radiation/brachytherapy: initial results. BJU Int. Jul 2008;102(1):93–6.PubMedCrossRefGoogle Scholar
  15. 15.
    Martin AD, Desai PJ, Nunez RN, et al. Does a history of previous surgery or radiation to the prostate affect outcomes of robot-assisted radical prostatectomy? BJU Int. Dec 2008;103(12):1696–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Jhaveri JK, Tan GY, Scherr DS, Tewari AK. Robot-assisted laparoscopic radical prostatectomy in the renal allograft transplant recipient. J Endourol. Nov 2008;22(11):2475–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Wolf JS, Jr., Bennett CJ, Dmochowski RR, Hollenbeck BK, Pearle MS, Schaeffer AJ. Best practice policy statement on urologic surgery antimicrobial prophylaxis. J Urol. Apr 2008;179(4):1379–90.PubMedCrossRefGoogle Scholar
  18. 18.
    Forrest JB, Clemens JQ, Finamore P, et al. AUA best practice statement for the prevention of deep vein thrombosis in patients undergoing urologic surgery. J Urol. Mar 2009;181(3):1170–7.PubMedCrossRefGoogle Scholar
  19. 19.
    Tsao AK, Smaldone MC, Averch TD, Jackman SV. Robot-assisted laparoscopic prostatectomy: the first 100 patients—improving patient safety and outcomes. J Endourol. Mar 2009;23(3):481–4.PubMedCrossRefGoogle Scholar
  20. 20.
    Guenaga KK, Matos D, Wille-Jorgensen P. Mechanical bowel preparation for elective colorectal surgery. Cochrane Database Syst Rev. 2009; Issue 1. Art. No.: CD001544. DOI: 10.1002/14651858.CD001544.pub3Google Scholar
  21. 21.
    Girardis M, Da Broi U, Antonutto G, Pasetto A. The effect of laparoscopic cholecystectomy on cardiovascular function and pulmonary gas exchange. Anesth Analg. Jul 1996;83(1):134–40.PubMedGoogle Scholar
  22. 22.
    Hardacre JM, Talamini MA. Pulmonary and hemodynamic changes during laparoscopy – are they important? Surgery Mar 2000;127(3):241–4.PubMedCrossRefGoogle Scholar
  23. 23.
    Phong SV, Koh LK. Anaesthesia for robotic-assisted radical prostatectomy: considerations for laparoscopy in the Trendelenburg position. Anaesth Intens Care. Apr 2007;35(2):281–5.Google Scholar
  24. 24.
    Menon M, Shrivastava A, Kaul S, et al. Vattikuti Institute prostatectomy: contemporary technique and analysis of results. Eur Urol. Mar 2007;51(3):648–57; discussion 648–57.PubMedCrossRefGoogle Scholar
  25. 25.
    Tewari AK, Rao SR. Anatomical foundations and surgical manoeuvres for precise identification of the prostatovesical junction during robotic radical prostatectomy. BJU Int. Oct 2006;98(4):833–7.PubMedCrossRefGoogle Scholar
  26. 26.
    Guillonneau B, Gupta R, El Fettouh H, Cathelineau X, Baumert H, Vallancien G. Laparoscopic [correction of laproscopic] management of rectal injury during laparoscopic [correction of laproscopic] radical prostatectomy. J Urol. May 2003;169(5):1694–6.PubMedCrossRefGoogle Scholar
  27. 27.
    Shekarriz B, Upadhyay J, Wood DP. Intraoperative, perioperative, and long-term complications of radical prostatectomy. Urol Clin North Am. Aug 2001;28(3):639–53.PubMedCrossRefGoogle Scholar
  28. 28.
    Yee DS, Ornstein DK. Repair of rectal injury during robotic-assisted laparoscopic prostatectomy. Urology. Aug 2008;72(2):428–31.PubMedCrossRefGoogle Scholar
  29. 29.
    Guillonneau B, Vallancien G. Laparoscopic radical prostatectomy: the Montsouris technique. J Urol. Jun 2000;163(6):1643–9.PubMedCrossRefGoogle Scholar
  30. 30.
    Costello AJ, Brooks M, Cole OJ. Anatomical studies of the neurovascular bundle and cavernosal nerves. BJU Int. Nov 2004;94(7):1071–6.PubMedCrossRefGoogle Scholar
  31. 31.
    Nielsen ME, Schaeffer EM, Marschke P, Walsh PC. High anterior release of the levator fascia improves sexual function following open radical retropubic prostatectomy. J Urol. Dec 2008;180(6):2557–64; discussion 2564.PubMedCrossRefGoogle Scholar
  32. 32.
    Kaul S, Savera A, Badani K, Fumo M, Bhandari A, Menon M. Functional outcomes and oncological efficacy of Vattikuti Institute prostatectomy with veil of Aphrodite nerve-sparing: an analysis of 154 consecutive patients. BJU Int. Mar 2006;97(3):467–72.PubMedCrossRefGoogle Scholar
  33. 33.
    Martinez-Salamanca JI, Ramanathan R, Rao S, et al. Second prize: pelvic neuroanatomy and innovative approaches to minimize nerve damage and maximize cancer control in patients undergoing robot-assisted radical prostatectomy. J Endourol. Jun 2008;22(6):1137–46.PubMedCrossRefGoogle Scholar
  34. 34.
    Rogers CG, Trock BP, Walsh PC. Preservation of accessory pudendal arteries during radical retropubic prostatectomy: surgical technique and results. Urology. Jul 2004;64(1):148–51.PubMedCrossRefGoogle Scholar
  35. 35.
    Finley DS, Osann K, Skarecky D, Ahlering TE. Hypothermic nerve-sparing radical prostatectomy: rationale, feasibility, and effect on early continence. Urology. Apr 2009;73(4):691–6.PubMedCrossRefGoogle Scholar
  36. 36.
    Guru KA, Perlmutter AE, Butt ZM, Peabody JO. Hydrodissection for preservation of neurovascular bundle during robot-assisted radical prostatectomy. Can J Urol. Apr 2008;15(2):4000–3.PubMedGoogle Scholar
  37. 37.
    Guru KA, Perlmutter AE, Sheldon MJ, et al. Apical margins after robot-assisted radical prostatectomy: does technique matter? J Endourol. Jan 2009;23(1):123–7.PubMedCrossRefGoogle Scholar
  38. 38.
    Nguyen MM, Turna B, Santos BR, et al. The use of an endoscopic stapler vs suture ligature for dorsal vein control in laparoscopic prostatectomy: operative outcomes. BJU Int. Feb 2008;101(4):463–6.PubMedGoogle Scholar
  39. 39.
    Deliveliotis C, Protogerou V, Alargof E, Varkarakis J. Radical prostatectomy: bladder neck preservation and puboprostatic ligament sparing – effects on continence and positive margins. Urology. Nov 2002;60(5):855–8.PubMedCrossRefGoogle Scholar
  40. 40.
    Stolzenburg JU, Liatsikos EN, Rabenalt R, et al. Nerve sparing endoscopic extraperitoneal radical prostatectomy – effect of puboprostatic ligament preservation on early continence and positive margins. Eur Urol. Jan 2006;49(1):103–11; discussion 111–2.PubMedCrossRefGoogle Scholar
  41. 41.
    Takenaka A, Tewari AK, Leung RA, et al. Preservation of the puboprostatic collar and puboperineoplasty for early recovery of urinary continence after robotic prostatectomy: anatomic basis and preliminary outcomes. Eur Urol. Feb 2007;51(2):433–40; discussion 440.PubMedCrossRefGoogle Scholar
  42. 42.
    Rocco F, Carmignani L, Acquati P, et al. Restoration of posterior aspect of rhabdosphincter shortens continence time after radical retropubic prostatectomy. J Urol. Jun 2006;175(6):2201–6.PubMedCrossRefGoogle Scholar
  43. 43.
    Tewari A, Jhaveri J, Rao S, et al. Total reconstruction of the vesico-urethral junction. BJU Int. Apr 2008;101(7):871–7.PubMedCrossRefGoogle Scholar
  44. 44.
    Menon M, Hemal AK, Tewari A, Shrivastava A, Bhandari A. The technique of apical dissection of the prostate and urethrovesical anastomosis in robotic radical prostatectomy. BJU Int. Apr 2004;93(6):715–9.PubMedCrossRefGoogle Scholar
  45. 45.
    Nguyen MM, Kamoi K, Stein RJ, et al. Early continence outcomes of posterior musculofascial plate reconstruction during robotic and laparoscopic prostatectomy. BJU Int. May 2008;101(9):1135–9.PubMedCrossRefGoogle Scholar
  46. 46.
    Coughlin G, Dangle PP, Patil NN, et al. Surgery illustrated – focus on details. Modified posterior reconstruction of the rhabdosphincter: application to robotic-assisted laparoscopic prostatectomy. BJU Int. Nov 2008;102(10):1482–5.PubMedCrossRefGoogle Scholar
  47. 47.
    Teber D, Erdogru T, Cresswell J, Gozen AS, Frede T, Rassweiler JJ. Analysis of three different vesicourethral anastomotic techniques in laparoscopic radical prostatectomy. World J Urol. Dec 2008;26(6):617–22.PubMedCrossRefGoogle Scholar
  48. 48.
    Gettman MT, Hoznek A, Salomon L, et al. Laparoscopic radical prostatectomy: description of the extraperitoneal approach using the da Vinci robotic system. J Urol. Aug 2003;170(2 Pt 1):416–9.PubMedCrossRefGoogle Scholar
  49. 49.
    Joseph JV, Rosenbaum R, Madeb R, Erturk E, Patel HR. Robotic extraperitoneal radical prostatectomy: an alternative approach. J Urol. Mar 2006;175(3 Pt 1):945–50; discussion 951.PubMedCrossRefGoogle Scholar
  50. 50.
    Brown JA, Rodin D, Lee B, Dahl DM. Transperitoneal versus extraperitoneal approach to laparoscopic radical prostatectomy: an assessment of 156 cases. Urology. Feb 2005;65(2):320–4.PubMedCrossRefGoogle Scholar
  51. 51.
    Atug F, Castle EP, Woods M, Srivastav SK, Thomas R, Davis R. Transperitoneal versus extraperitoneal robotic-assisted radical prostatectomy: is one better than the other? Urology. Nov 2006;68(5):1077–81.PubMedCrossRefGoogle Scholar
  52. 52.
    Madi R, Daignault S, Wood DP. Extraperitoneal v intraperitoneal robotic prostatectomy: analysis of operative outcomes. J Endourol. Dec 2007;21(12):1553–7.PubMedCrossRefGoogle Scholar
  53. 53.
    Rehman J, Chughtai B, Guru K, Shabsigh R, Samadi DB. Management of an enlarged median lobe with ureteral orifices at the margin of bladder neck during robotic-assisted laparoscopic prostatectomy. Can J Urol. Feb 2009;16(1):4490–4.PubMedGoogle Scholar
  54. 54.
    Jenkins LC, Nogueira M, Wilding GE, et al. Median lobe in robot-assisted radical prostatectomy: evaluation and management. Urology. May 2008;71(5):810–3.PubMedCrossRefGoogle Scholar
  55. 55.
    El-Hakim A, Leung RA, Richstone L, Kim TS, Te AE, Tewari AK. Athermal robotic technique of prostatectomy in patients with large prostate glands (>75 g): technique and initial results. BJU Int. Jul 2006;98(1):47–9.PubMedCrossRefGoogle Scholar
  56. 56.
    Sarle R, Tewari A, Hemal AK, Menon M. Robotic-assisted anatomic radical prostatectomy: technical difficulties due to a large median lobe. Urol Int. 2005;74(1):92–4.PubMedCrossRefGoogle Scholar
  57. 57.
    Jaffe J, Stakhovsky O, Cathelineau X, Barret E, Vallancien G, Rozet F. Surgical outcomes for men undergoing laparoscopic radical prostatectomy after transurethral resection of the prostate. J Urol. Aug 2007;178(2):483–7; discussion 487.PubMedCrossRefGoogle Scholar
  58. 58.
    Meeks JJ, Zhao L, Greco KA, Macejko A, Nadler RB. Impact of prostate median lobe anatomy on robotic-assisted laparoscopic prostatectomy. Urology. Feb 2009;73(2):323–7.PubMedCrossRefGoogle Scholar
  59. 59.
    Vallancien G, Cathelineau X, Baumert H, Doublet JD, Guillonneau B. Complications of transperitoneal laparoscopic surgery in urology: review of 1,311 procedures at a single center. J Urol. Jul 2002;168(1):23–6.PubMedCrossRefGoogle Scholar
  60. 60.
    Schraudenbach P, Bermejo CE. Management of the complications of radical prostatectomy. Curr Urol Rep. May 2007;8(3):197–202.PubMedCrossRefGoogle Scholar
  61. 61.
    Dinlenc CZ, Gerber E, Wagner JR. Ureteral reimplantation during robot assisted laparoscopic radical prostatectomy. J Urol. Sep 2004;172(3):905.PubMedCrossRefGoogle Scholar
  62. 62.
    Larson JA, Tomaszewski JJ, Smaldone MC, Jackman SV. Robotic assisted laparoscopic extravesical ureteroneocystostomy for management of adult ureteral duplication with upper pole prostatic urethral insertion. JSLS. 2009;13(3):458–61.PubMedGoogle Scholar
  63. 63.
    Elliott SP, McAninch JW. Ureteral injuries: external and iatrogenic. Urol Clin North Am. Feb 2006;33(1):55–66, vi.PubMedCrossRefGoogle Scholar
  64. 64.
    Stephenson AJ, Scardino PT, Eastham JA, et al. Postoperative nomogram predicting the 10-year probability of prostate cancer recurrence after radical prostatectomy. J Clin Oncol. 1 Oct 2005;23(28):7005–12.PubMedCrossRefGoogle Scholar
  65. 65.
    Vickers AJ, Bianco FJ, Serio AM, et al. The surgical learning curve for prostate cancer control after radical prostatectomy. J Natl Cancer Inst. 1 Aug 2007;99(15):1171–7.PubMedCrossRefGoogle Scholar
  66. 66.
    Ahlering TE, Skarecky D, Lee D, Clayman RV. Successful transfer of open surgical skills to a laparoscopic environment using a robotic interface: initial experience with laparoscopic radical prostatectomy. J Urol. Nov 2003;170(5):1738–41.PubMedCrossRefGoogle Scholar
  67. 67.
    Atug F, Castle EP, Srivastav SK, Burgess SV, Thomas R, Davis R. Positive surgical margins in robotic-assisted radical prostatectomy: impact of learning curve on oncologic outcomes. Eur Urol. May 2006;49(5):866–71; discussion 871–862.PubMedCrossRefGoogle Scholar
  68. 68.
    Sofer M, Hamilton-Nelson KL, Civantos F, Soloway MS. Positive surgical margins after radical retropubic prostatectomy: the influence of site and number on progression. J Urol. Jun 2002;167(6):2453–6.PubMedCrossRefGoogle Scholar
  69. 69.
    Smith JA, Jr., Chan RC, Chang SS, et al. A comparison of the incidence and location of positive surgical margins in robotic assisted laparoscopic radical prostatectomy and open retropubic radical prostatectomy. J Urol. Dec 2007;178(6):2385–9; discussion 2389–90.PubMedCrossRefGoogle Scholar
  70. 70.
    Ahlering TE, Eichel L, Edwards RA, Lee DI, Skarecky DW. Robotic radical prostatectomy: a technique to reduce pT2 positive margins. Urology. Dec 2004;64(6):1224–8.PubMedCrossRefGoogle Scholar
  71. 71.
    Weizer AZ, Ye Z, Hollingsworth JM, et al. Adoption of new technology and healthcare quality: surgical margins after robotic prostatectomy. Urology. Jul 2007;70(1):96–100.PubMedCrossRefGoogle Scholar
  72. 72.
    Patel VR, Shah S, Arend D. Histopathologic outcomes of robotic radical prostatectomy. Sc World J. 2006;6:2566–72.CrossRefGoogle Scholar
  73. 73.
    Chuang AY, Nielsen ME, Hernandez DJ, Walsh PC, Epstein JI. The significance of positive surgical margin in areas of capsular incision in otherwise organ confined disease at radical prostatectomy. J Urol. Oct 2007;178(4 Pt 1):1306–10.PubMedCrossRefGoogle Scholar
  74. 74.
    Shuford MD, Cookson MS, Chang SS, et al. Adverse prognostic significance of capsular incision with radical retropubic prostatectomy. J Urol. Jul 2004;172(1):119–23.PubMedCrossRefGoogle Scholar
  75. 75.
    Patel VR, Thaly R, Shah K. Robotic radical prostatectomy: outcomes of 500 cases. BJU Int. May 2007;99(5):1109–12.PubMedCrossRefGoogle Scholar
  76. 76.
    Parsons JK, Bennett JL. Outcomes of retropubic, laparoscopic, and robotic-assisted prostatectomy. Urology. Aug 2008;72(2):412–6.PubMedCrossRefGoogle Scholar
  77. 77.
    Skarecky DW, Brenner M, Rajan S, et al. Zero positive surgical margins after radical prostatectomy: is the end in sight. Expert Rev Med Devices. Nov 2008;5(6):709–17.PubMedCrossRefGoogle Scholar
  78. 78.
    Burnett AL, Aus G, Canby-Hagino ED, et al. Erectile function outcome reporting after clinically localized prostate cancer treatment. J Urol. Aug 2007;178(2):597–601.PubMedCrossRefGoogle Scholar
  79. 79.
    Tewari A, Srivasatava A, Menon M. A prospective comparison of radical retropubic and robot-assisted prostatectomy: experience in one institution. BJU Int. Aug 2003;92(3):205–10.PubMedCrossRefGoogle Scholar
  80. 80.
    Bentas W, Wolfram M, Jones J, Brautigam R, Kramer W, Binder J. Robotic technology and the translation of open radical prostatectomy to laparoscopy: the early Frankfurt experience with robotic radical prostatectomy and one year follow-up. Eur Urol. Aug 2003;44(2):175–81.PubMedCrossRefGoogle Scholar
  81. 81.
    Patel VR, Tully AS, Holmes R, Lindsay J. Robotic radical prostatectomy in the community setting – the learning curve and beyond: initial 200 cases. J Urol. Jul 2005;174(1):269–72.PubMedCrossRefGoogle Scholar
  82. 82.
    Hakimi AA, Blitstein J, Feder M, Shapiro E, Ghavamian R. Direct comparison of surgical and functional outcomes of robotic-assisted versus pure laparoscopic radical prostatectomy: single-surgeon experience. Urology. Jan 2009;73(1):119–23.PubMedCrossRefGoogle Scholar
  83. 83.
    Tewari AK, Bigelow K, Rao S, et al. Anatomic restoration technique of continence mechanism and preservation of puboprostatic collar: a novel modification to achieve early urinary continence in men undergoing robotic prostatectomy. Urology. Apr 2007;69(4):726–31.PubMedCrossRefGoogle Scholar
  84. 84.
    Glickman L, Godoy G, Lepor H. Changes in continence and erectile function between 2 and 4 years after radical prostatectomy. J Urol. Feb 2009;181(2):731–5.PubMedCrossRefGoogle Scholar
  85. 85.
    Walsh PC, Marschke P, Ricker D, Burnett AL. Patient-reported urinary continence and sexual function after anatomic radical prostatectomy. Urology. Jan 2000;55(1):58–61.PubMedCrossRefGoogle Scholar
  86. 86.
    Rodriguez E, Jr, Finley DS, Skarecky D, Ahlering TE. Single institution 2-year patient reported validated sexual function outcomes after nerve sparing robot assisted radical prostatectomy. J Urol. Jan 2009;181(1):259–63.PubMedCrossRefGoogle Scholar
  87. 87.
    Menon M, Kaul S, Bhandari A, Shrivastava A, Tewari A, Hemal A. Potency following robotic radical prostatectomy: a questionnaire based analysis of outcomes after conventional nerve sparing and prostatic fascia sparing techniques. J Urol. Dec 2005;174(6):2291–6, discussion 2296.PubMedCrossRefGoogle Scholar
  88. 88.
    Ahlering TE, Eichel L, Chou D, Skarecky DW. Feasibility study for robotic radical prostatectomy cautery-free neurovascular bundle preservation. Urology. May 2005;65(5):994–7.PubMedCrossRefGoogle Scholar
  89. 89.
    Mulhall JP, Secin FP, Guillonneau B. Artery sparing radical prostatectomy – myth or reality? J Urol Mar 2008;179(3):827–31.PubMedCrossRefGoogle Scholar
  90. 90.
    Borboroglu PG, Sands JP, Roberts JL, Amling CL. Risk factors for vesicourethral anastomotic stricture after radical prostatectomy. Urology. Jul 2000;56(1):96–100.PubMedCrossRefGoogle Scholar
  91. 91.
    Msezane LP, Reynolds WS, Gofrit ON, Shalhav AL, Zagaja GP, Zorn KC. Bladder neck contracture after robot-assisted laparoscopic radical prostatectomy: evaluation of incidence and risk factors and impact on urinary function. J Endourol. Jan 2008;22(1):97–104.PubMedGoogle Scholar
  92. 92.
    Webb DR, Sethi K, Gee K. An analysis of the causes of bladder neck contracture after open and robot-assisted laparoscopic radical prostatectomy. BJU Int. Apr 2009;103(7):957–63.PubMedCrossRefGoogle Scholar
  93. 93.
    El-Hakim A, Leung RA, Tewari A. Robotic prostatectomy: a pooled analysis of published literature. Expert Rev Anticancer Ther. Jan 2006;6(1):11–20.PubMedCrossRefGoogle Scholar
  94. 94.
    Park R, Martin S, Goldberg JD, Lepor H. Anastomotic strictures following radical prostatectomy: insights into incidence, effectiveness of intervention, effect on continence, and factors predisposing to occurrence. Urology. Apr 2000;57(4):742–6.CrossRefGoogle Scholar
  95. 95.
    van Velthoven RF, Ahlering TE, Peltier A, Skarecky DW, Clayman RV. Technique for laparoscopic running urethrovesical anastomosis: the single knot method. Urology. Apr 2003;61(4):699–702.PubMedCrossRefGoogle Scholar
  96. 96.
    Herrmann TR, Rabenalt R, Stolzenburg JU, et al. Oncological and functional results of open, robot-assisted and laparoscopic radical prostatectomy: does surgical approach and surgical experience matter? World J Urol. Apr 2007;25(2):149–60.PubMedCrossRefGoogle Scholar
  97. 97.
    Krambeck AE, DiMarco DS, Rangel LJ, et al. Radical prostatectomy for prostatic adenocarcinoma: a matched comparison of open retropubic and robot-assisted techniques. BJU Int. Feb 2009;103(4):448–53.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Marc C. Smaldone
    • 1
    Email author
  • Tina K. Schuster
    • 2
  • Stephen V. Jackman
    • 2
  1. 1.Department of Surgical OncologyFox Chase Cancer CenterPhiladelphiaUSA
  2. 2.Department of UrologyUniversity of Pittsburgh Medical CenterPittsburghUSA

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