Section of Urology, Department of Surgery, University of Chicago Medical Center, Chicago, Illinois 60637, USA.
J Endourol. 2009 Dec;23(12):1995-9. doi: 10.1089/end.2009.0117.
Posterior rhabdosphincter (PR) reconstruction during robot-assisted radical prostatectomy (RARP) was introduced in an attempt to improve postoperative continence. In the present study, we evaluate time to achieve continence in patients who are undergoing RARP with and without PR reconstruction.
A prospective RARP database was searched for most recent cases that were accomplished with PR reconstruction (group 1, n = 69) or with standard technique (group 2, n = 63). We performed the analysis applying two definitions of continence: 0 pads per day or 0-1 security pad per day. Patients were evaluated by telephone interview. Statistical analysis was carried out using the Kaplan-Meier method and log-rank test.
With PR reconstruction, continence was improved when defined as 0-1 security pad per day (median time of 90 vs 150 days; P = 0.01). This difference did not achieve statistical significance when continence was defined as 0 pads per day (P = 0.12).
A statistically significant improvement in continence rate and time to achieve continence is seen in patients who are undergoing PR reconstruction during RARP, with continence defined as 0-1 security/safety pad per day. A larger, prospective and randomized study is needed to better understand the impact of this technique on postoperative continence.
机器人辅助根治性前列腺切除术（RARP）中引入了后阴部重建（PR），旨在改善术后控尿功能。本研究旨在评估接受 RARP 手术且行 PR 重建（组 1，n = 69）或行标准技术（组 2，n = 63）的患者实现控尿的时间。
对最近完成的 RARP 数据库进行前瞻性搜索，其中包括 PR 重建组（组 1，n = 69）和标准技术组（组 2，n = 63）。我们通过电话访谈对患者进行评估。应用两种控尿定义进行分析：每天 0 片尿垫或每天 0-1 片安全尿垫。采用 Kaplan-Meier 法和对数秩检验进行统计学分析。
定义为每天使用 0-1 片安全尿垫时，PR 重建后控尿功能得到改善（中位数时间为 90 天 vs 150 天；P = 0.01）。当定义为每天使用 0 片尿垫时，差异无统计学意义（P = 0.12）。
在接受 RARP 中 PR 重建的患者中，控尿率和达到控尿所需时间有显著统计学改善，以每天使用 0-1 片安全/卫生尿垫为标准。需要更大、前瞻性和随机研究来更好地了解该技术对术后控尿的影响。
