腹腔鏡下根治的前立腺摘除術後の早期尿失禁回復に対する尿道周囲構造補強術の効果：後向き研究

This retrospective comparative study aims to evaluate the safety and efficacy of a novel periurethral structural reinforcement (PSR) technique for enhancing early urinary continence recovery after laparoscopic radical prostatectomy (LRP).

Clinical records of 140 prostate cancer patients undergoing LRP between March 2022 to August 2023 were reviewed. Participants were divided into modified (PSR) and conventional (standard anastomosis) groups. The PSR technique augments standard posterior reconstruction by incorporating circumferential support sutures, aimed at reconstructing key surgical-damaged periurethral supports. Continence status (≤1 pad/day) were analyzed at catheter removal, 1, 2 4, and 12 weeks following surgery. Operative time, complications and pathologic characteristics were compared between 2 groups.

Baseline characteristics were comparable among 2 groups. The modified group maintained superior continence recovery at all time intervals: 16.0% vs. 0% (immediate, P < 0.001), 20.0% vs. 6.7% (1 week, P = 0.018), 52.0% vs. 27.8% (4 weeks, P = 0.004), and 82.0% vs. 52.2% (12 weeks, P < 0.001), respectively. Complication rates showed no significant difference (P > 0.05).

The PSR technique is a safe and simple technique to accelerate early urinary continence recovery following LRP. Nevertheless, the generalizability of these outcomes require rigorous validation through a large-scale multicenter randomized controlled trial.