The pubovesical complex-sparing technique on laparoscopic radical prostatectomy
ABSTRACT Introduction: Preservation of urinary continence is a great challenge in Radical Prostatectomy. In order to improve functional results, Asimakopoulos et al. (2010) described a robot-assisted surgical technique with preservation of the pubovesical complex (PVC). We present a pure laparoscop...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Sociedade Brasileira de Urologia
|
| Series: | International Brazilian Journal of Urology |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382018000400844&lng=en&tlng=en |
| _version_ | 1818321743526232064 |
|---|---|
| author | Rafael Batista Rebouças Rodrigo Campos Monteiro João Paulo Pereira Lima Filipe de Pádua B. F. Almeida Cesar Araujo Britto Marcos Tobias Machado Carlo Passerotti |
| author_facet | Rafael Batista Rebouças Rodrigo Campos Monteiro João Paulo Pereira Lima Filipe de Pádua B. F. Almeida Cesar Araujo Britto Marcos Tobias Machado Carlo Passerotti |
| author_sort | Rafael Batista Rebouças |
| collection | DOAJ |
| description | ABSTRACT Introduction: Preservation of urinary continence is a great challenge in Radical Prostatectomy. In order to improve functional results, Asimakopoulos et al. (2010) described a robot-assisted surgical technique with preservation of the pubovesical complex (PVC). We present a pure laparoscopic execution. Presentation: A 61-year-old male patient with a diagnosis of prostate cancer, with PSA 6.54ng/ml, DRE: T1C and Gleason 6 (3+3) 1/12 fragments. All therapeutic possibilities were discussed, including active surveillance. The patient opted for surgical treatment. A transperitoneal technique was used. We started the dissection on the left side, in the limit between the detrusor and the base of the prostate. The left seminal vesicle was dissected and left neurovascular bundle released by a high anterior dissection. We repeated the same procedure on the right side. The urethra was then divided, prostatic apex was laterally drawn and PVC was released. The bladder neck was divided and an urethrovesical anastomosis was achieved. A pelvic drain was placed. Results: The total operative time was 150 minutes. The estimated blood loss was 300mL. The drain was removed on the 1st postoperative day and the patient was discharged. The Foley catheter was removed after 7 days and the patient remained completely dry. Hystopathology revealed adenocarcinoma Gleason 6, negative margins. PSA after 30 days was <0.04ng/mL, and the patient reported partial penile erection. Conclusion: The Pubovesical Complex-Sparing Technique on Laparoscopic Radical Prostatectomy was feasible and safe. Further adequately designed studies are needed to confirm whether this technique enhances early functional outcomes. |
| first_indexed | 2024-12-13T10:45:45Z |
| format | Article |
| id | doaj.art-d60a2740be8945f695ccc242ecacfdf4 |
| institution | Directory Open Access Journal |
| issn | 1677-6119 |
| language | English |
| last_indexed | 2024-12-13T10:45:45Z |
| publisher | Sociedade Brasileira de Urologia |
| record_format | Article |
| series | International Brazilian Journal of Urology |
| spelling | doaj.art-d60a2740be8945f695ccc242ecacfdf42022-12-21T23:50:12ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-611944484484510.1590/s1677-5538.ibju.2017.0359S1677-55382018000400844The pubovesical complex-sparing technique on laparoscopic radical prostatectomyRafael Batista RebouçasRodrigo Campos MonteiroJoão Paulo Pereira LimaFilipe de Pádua B. F. AlmeidaCesar Araujo BrittoMarcos Tobias MachadoCarlo PasserottiABSTRACT Introduction: Preservation of urinary continence is a great challenge in Radical Prostatectomy. In order to improve functional results, Asimakopoulos et al. (2010) described a robot-assisted surgical technique with preservation of the pubovesical complex (PVC). We present a pure laparoscopic execution. Presentation: A 61-year-old male patient with a diagnosis of prostate cancer, with PSA 6.54ng/ml, DRE: T1C and Gleason 6 (3+3) 1/12 fragments. All therapeutic possibilities were discussed, including active surveillance. The patient opted for surgical treatment. A transperitoneal technique was used. We started the dissection on the left side, in the limit between the detrusor and the base of the prostate. The left seminal vesicle was dissected and left neurovascular bundle released by a high anterior dissection. We repeated the same procedure on the right side. The urethra was then divided, prostatic apex was laterally drawn and PVC was released. The bladder neck was divided and an urethrovesical anastomosis was achieved. A pelvic drain was placed. Results: The total operative time was 150 minutes. The estimated blood loss was 300mL. The drain was removed on the 1st postoperative day and the patient was discharged. The Foley catheter was removed after 7 days and the patient remained completely dry. Hystopathology revealed adenocarcinoma Gleason 6, negative margins. PSA after 30 days was <0.04ng/mL, and the patient reported partial penile erection. Conclusion: The Pubovesical Complex-Sparing Technique on Laparoscopic Radical Prostatectomy was feasible and safe. Further adequately designed studies are needed to confirm whether this technique enhances early functional outcomes.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382018000400844&lng=en&tlng=en |
| spellingShingle | Rafael Batista Rebouças Rodrigo Campos Monteiro João Paulo Pereira Lima Filipe de Pádua B. F. Almeida Cesar Araujo Britto Marcos Tobias Machado Carlo Passerotti The pubovesical complex-sparing technique on laparoscopic radical prostatectomy International Brazilian Journal of Urology |
| title | The pubovesical complex-sparing technique on laparoscopic radical prostatectomy |
| title_full | The pubovesical complex-sparing technique on laparoscopic radical prostatectomy |
| title_fullStr | The pubovesical complex-sparing technique on laparoscopic radical prostatectomy |
| title_full_unstemmed | The pubovesical complex-sparing technique on laparoscopic radical prostatectomy |
| title_short | The pubovesical complex-sparing technique on laparoscopic radical prostatectomy |
| title_sort | pubovesical complex sparing technique on laparoscopic radical prostatectomy |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382018000400844&lng=en&tlng=en |
| work_keys_str_mv | AT rafaelbatistareboucas thepubovesicalcomplexsparingtechniqueonlaparoscopicradicalprostatectomy AT rodrigocamposmonteiro thepubovesicalcomplexsparingtechniqueonlaparoscopicradicalprostatectomy AT joaopaulopereiralima thepubovesicalcomplexsparingtechniqueonlaparoscopicradicalprostatectomy AT filipedepaduabfalmeida thepubovesicalcomplexsparingtechniqueonlaparoscopicradicalprostatectomy AT cesararaujobritto thepubovesicalcomplexsparingtechniqueonlaparoscopicradicalprostatectomy AT marcostobiasmachado thepubovesicalcomplexsparingtechniqueonlaparoscopicradicalprostatectomy AT carlopasserotti thepubovesicalcomplexsparingtechniqueonlaparoscopicradicalprostatectomy AT rafaelbatistareboucas pubovesicalcomplexsparingtechniqueonlaparoscopicradicalprostatectomy AT rodrigocamposmonteiro pubovesicalcomplexsparingtechniqueonlaparoscopicradicalprostatectomy AT joaopaulopereiralima pubovesicalcomplexsparingtechniqueonlaparoscopicradicalprostatectomy AT filipedepaduabfalmeida pubovesicalcomplexsparingtechniqueonlaparoscopicradicalprostatectomy AT cesararaujobritto pubovesicalcomplexsparingtechniqueonlaparoscopicradicalprostatectomy AT marcostobiasmachado pubovesicalcomplexsparingtechniqueonlaparoscopicradicalprostatectomy AT carlopasserotti pubovesicalcomplexsparingtechniqueonlaparoscopicradicalprostatectomy |