Postoperative cystogram findings predict recovery of urinary continence after robot ‐assisted laparoscopic radical prostatectomy

ObjectivesTo assess the association between postoperative cystogram findings and subsequent outcomes on urinary continence after robot ‐assisted laparoscopic radical prostatectomy (RALP).MethodsA retrospective review of 250 consecutive patients who were observed for at least 12  months after RALP. The postoperative cystogram findings examined were: the location of the bladder neck, degree of bladder abnormalities, and presence of outflow of contrast medium into the urethra during the filling phase of cystography. The continence status based on pad usage was recorded. Tho se who required no pad or only a safety pad were defined as continent.ResultsPatients with a bladder neck location above the middle of the pubic symphysis height exhibited significantly higher continence levels than those with a lower bladder neck location at both postoperative 3 and 12  months (P 
Source: LUTS: Lower Urinary Tract Symptoms - Category: Urology & Nephrology Authors: Tags: ORIGINAL ARTICLE Source Type: research

Related Links:

ConclusionsThe developed HTA appears to have some utility, but needs evaluation in larger studies. It can potentially be used as a training aid, and as a checklist for evaluating surgical performance.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
Authors: Huh JS, Kim YJ, Kim SD, Park KK Abstract PURPOSE: To analyze the clinical parameters correlated with early recovery of urinary continence after radical prostatectomy, with a focus on urethral mobility during pelvic contraction at catheter removal. METHODS: We prospectively analyzed 67 patients who underwent prostatectomy for prostate cancer at Jeju National University Hospital from January 2015 to June 2018. At the time of catheter removal, a cystography was performed in 67 men (median age, 65 years; range, 55-76 years) who had undergone robot-assisted laparoscopic prostatectomy. The vertical length of...
Source: International Neurourology Journal - Category: Urology & Nephrology Tags: Int Neurourol J Source Type: research
In this narrative review article, the authors discuss the anatomy, nomenclature, history, approaches (posteriorvs. lateral vs. subcostal), techniques, pharmacology, indications, and complications of transversus abdominis plane blocks, as well as possible alternative truncal blocks. Despite the scarcity of evidence and contradictory findings, certain clinical suggestions can nonetheless be made. Overall transversus abdominis plane blocks appear most beneficial in the setting of open appendectomy (posterior or lateral approach). Lateral transversus abdominis plane blocks are not suggested for laparoscopic hysterectomy, lapar...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
AbstractBackgroundTo comprehensively evaluate the efficacy and safety of Retzius sparing (RS) for men undergoing robot-assisted laparoscopic prostatectomy (RARP).MethodsWe searched four electronic databases and reference lists of relevant studies for eligible research published before March 11, 2019. After quality assessment, eligible studies were synthesized for relevant outcomes, including positive surgical margin (PSM), continence, incontinence, complication, console time, and hospital stay.ResultsTwo randomized clinical trials and four observational studies were included in this study. Quantitative syntheses revealed s...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
CONCLUSIONS: The reconstruction of the rhabdosphincter is the only technique that has shown improved functional results through randomized trials. The current evidence is limited and heterogenous, and more studies with consistent criteria are needed in order to establish a standard surgical technique. PMID: 31606163 [PubMed - as supplied by publisher]
Source: Actas Urologicas Espanolas - Category: Urology & Nephrology Authors: Tags: Actas Urol Esp Source Type: research
Journal of Endourology, Ahead of Print.
Source: Journal of Endourology - Category: Urology & Nephrology Authors: Source Type: research
AbstractFocal or non-focal/extensive extraprostatic extension of prostate carcinoma is an important pathologic prognostic parameter to be reported after radical prostatectomy. Currently, there is no agreement on how to measure and what are the best cutoff points to be used in practice. We hypothesized that digital microscopy would potentially provide more objective measurements of extraprostatic extension, thus better defining its clinical significance. To further our knowledge on digital prostate pathology, we evaluated the status of extraprostatic extension in 107 consecutive laparoscopic radical prostatectomy samples, u...
Source: Virchows Archiv - Category: Pathology Source Type: research
CONCLUSIONS: The INM is a fundamental tool to allow an improved identification of nerve structures during RP and PNS in order to preserve them. It also helps with the diagnosis of PNS. PMID: 31579045 [PubMed - in process]
Source: Archivos Espanoles de Urologia - Category: Urology & Nephrology Tags: Arch Esp Urol Source Type: research
CONCLUSION: Patients with BNS had a better chance to be pad-free at 7 days after catheter removal and had a significant shorter time to catheter removal. However, this beneficial effect disappeared with time and no differences in continence rates at 3 months and 1 year were recorded. Moreover, BNS did not negatively affect positive margin or BCR rates. PMID: 31586543 [PubMed - as supplied by publisher]
Source: Urologic Oncology - Category: Urology & Nephrology Authors: Tags: Urol Oncol Source Type: research
This retrospective study by Baber et al1 analyzed 460 robotic assisted laparoscopic radical prostatectomies (RALP) to examine the effect of resident involvement in the procedure on operative time, complications, as well as patient functional and oncologic outcomes. All cases were performed by a single attending surgeon between 2007 and 2016. Residents underwent graduated robotic training, including a step-wise progression of tasks according to degree of difficulty. Not surprisingly, operative and robotic time increased with resident involvement compared to cases with only an attending surgeon.
Source: Urology - Category: Urology & Nephrology Authors: Source Type: research
More News: Laparoscopy | Prostatectomy | Urology & Nephrology