The impact of bladder neck sparing on urinary continence during laparoscopic radical prostatectomy; Results from a high volume centre

Objective: To evaluate the effects of bladder neck reconstruction techniques on early continence after laparoscopic radical prostatectomy (LRP). Materials and methods: This non-randomized retrospective study analyzed prospectively collected data concerning LRP. In total, 3107 patients underwent LRP...

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Main Authors: Ali Serdar Gozen, Yigit Akin, Mutlu Ates, Marcel Fiedler, Jens Rassweiler
Format: Article
Language:English
Published: PAGEPress Publications 2017-10-01
Series:Archivio Italiano di Urologia e Andrologia
Subjects:
Online Access:http://pagepressjournals.org/index.php/aiua/article/view/6785
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author Ali Serdar Gozen
Yigit Akin
Mutlu Ates
Marcel Fiedler
Jens Rassweiler
author_facet Ali Serdar Gozen
Yigit Akin
Mutlu Ates
Marcel Fiedler
Jens Rassweiler
author_sort Ali Serdar Gozen
collection DOAJ
description Objective: To evaluate the effects of bladder neck reconstruction techniques on early continence after laparoscopic radical prostatectomy (LRP). Materials and methods: This non-randomized retrospective study analyzed prospectively collected data concerning LRP. In total, 3107 patients underwent LRP between March 1999 and December 2016. Exclusion criteria were preoperative urinary incontinence, previous history of external beam radiotherapy, co-morbities which may affect urinary continence such as diabetes mellitus and/or neurogenic disorders, irregular followup, and follow-up shorter than 24 months. All patients were divided into one of three groups, posterior reconstruction being performed in Group 1 (n = 112), anterior reconstruction in Group 2 (n = 762), and bladder neck sparing (BNS) in Group 3 (n = 987). Demographic and pre-, peri-, and postoperative data were collected. Multivariate analyses were performed to determine factors affecting early continence after LRP. Results: 1861 patients were enrolled in the study. The mean follow-up period was 48.12 ± 29.8 months, and subjects’ mean age was 63.6 ± 6.2 years. There was no significant difference among the groups in terms of demographic or preoperative data. Postoperative data, including oncological outcomes, were similar among the groups. The level of early continence was higher in Group 3 than in the other groups (p < 0.001). Multivariate analyses identified BNS and age as parameters significantly affecting early continence levels after LRP (p < 0.001 and p < 0.001, respectively). Bladder neck reconstruction provided less earlier continence than BNS.
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spelling doaj.art-668731b1caf543b79caf89d8bb3e15d12022-12-21T19:04:25ZengPAGEPress PublicationsArchivio Italiano di Urologia e Andrologia1124-35622282-41972017-10-0189318619110.4081/aiua.2017.3.1865412The impact of bladder neck sparing on urinary continence during laparoscopic radical prostatectomy; Results from a high volume centreAli Serdar Gozen0Yigit Akin1Mutlu Ates2Marcel Fiedler3Jens Rassweiler4Department of Urology, SLK-Klinikum Heilbronn, University of Heidelberg, HeilbronnDepartment of Urology, Izmir Katip Celebi University School of Medicine, IzmirDepartment of Urology, Antalya Teaching and Research Hospital, AntalyaDepartment of Urology, SLK-Klinikum Heilbronn, University of Heidelberg, HeilbronnDepartment of Urology, SLK-Klinikum Heilbronn, University of Heidelberg, HeilbronnObjective: To evaluate the effects of bladder neck reconstruction techniques on early continence after laparoscopic radical prostatectomy (LRP). Materials and methods: This non-randomized retrospective study analyzed prospectively collected data concerning LRP. In total, 3107 patients underwent LRP between March 1999 and December 2016. Exclusion criteria were preoperative urinary incontinence, previous history of external beam radiotherapy, co-morbities which may affect urinary continence such as diabetes mellitus and/or neurogenic disorders, irregular followup, and follow-up shorter than 24 months. All patients were divided into one of three groups, posterior reconstruction being performed in Group 1 (n = 112), anterior reconstruction in Group 2 (n = 762), and bladder neck sparing (BNS) in Group 3 (n = 987). Demographic and pre-, peri-, and postoperative data were collected. Multivariate analyses were performed to determine factors affecting early continence after LRP. Results: 1861 patients were enrolled in the study. The mean follow-up period was 48.12 ± 29.8 months, and subjects’ mean age was 63.6 ± 6.2 years. There was no significant difference among the groups in terms of demographic or preoperative data. Postoperative data, including oncological outcomes, were similar among the groups. The level of early continence was higher in Group 3 than in the other groups (p < 0.001). Multivariate analyses identified BNS and age as parameters significantly affecting early continence levels after LRP (p < 0.001 and p < 0.001, respectively). Bladder neck reconstruction provided less earlier continence than BNS.http://pagepressjournals.org/index.php/aiua/article/view/6785Bladder neckLaparoscopySurgeryProstate cancerRadical prostatectomyUrinary continence
spellingShingle Ali Serdar Gozen
Yigit Akin
Mutlu Ates
Marcel Fiedler
Jens Rassweiler
The impact of bladder neck sparing on urinary continence during laparoscopic radical prostatectomy; Results from a high volume centre
Archivio Italiano di Urologia e Andrologia
Bladder neck
Laparoscopy
Surgery
Prostate cancer
Radical prostatectomy
Urinary continence
title The impact of bladder neck sparing on urinary continence during laparoscopic radical prostatectomy; Results from a high volume centre
title_full The impact of bladder neck sparing on urinary continence during laparoscopic radical prostatectomy; Results from a high volume centre
title_fullStr The impact of bladder neck sparing on urinary continence during laparoscopic radical prostatectomy; Results from a high volume centre
title_full_unstemmed The impact of bladder neck sparing on urinary continence during laparoscopic radical prostatectomy; Results from a high volume centre
title_short The impact of bladder neck sparing on urinary continence during laparoscopic radical prostatectomy; Results from a high volume centre
title_sort impact of bladder neck sparing on urinary continence during laparoscopic radical prostatectomy results from a high volume centre
topic Bladder neck
Laparoscopy
Surgery
Prostate cancer
Radical prostatectomy
Urinary continence
url http://pagepressjournals.org/index.php/aiua/article/view/6785
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