Urinary Continence After Robot-Assisted Laparoscopic Radical Prostatectomy Using the Peritoneal Fixation Technique

Area of Science:

• Urology
• Surgical Oncology
• Reconstructive Surgery

Background:

• Retzius-sparing techniques for prostate cancer demonstrate positive outcomes for urinary continence.
• Anterior bladder wall connection to the abdominal wall post-Retzius-sparing surgery is linked to improved continence.

Purpose of the Study:

• To evaluate the efficacy of the Peritoneal Fixation technique in enhancing urinary continence recovery after robot-assisted laparoscopic radical prostatectomy.
• To assess if suturing the anterior bladder wall to the abdominal wall contributes to better urinary continence outcomes.

Main Methods:

• A comparative study included 54 patients undergoing robot-assisted laparoscopic radical prostatectomy.
• Patients were divided into two groups: Peritoneal Fixation (n=27) and conventional surgery (n=27).
• Urinary incontinence was assessed on catheter removal day and at 1 month post-surgery; posterior urethral angle was measured.

Main Results:

• The Peritoneal Fixation group showed a significantly higher continence rate on catheter removal day (40.7% vs. 7.4%, p<0.05).
• At 1 month post-surgery, the Peritoneal Fixation group had a continence rate of 44.4% compared to 29.6% in the conventional group (p=0.26).
• A significant difference in posterior urethral angle changes between groups indicated urethral repositioning in the Peritoneal Fixation group (-3.0° vs. 2.7°, p<0.05).

Conclusions:

• The Peritoneal Fixation technique shows potential for improving urinary continence after radical prostatectomy.
• This surgical approach may offer advantages in early continence recovery compared to conventional methods.