Urologic Oncology, The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Yonsei Med J. 2010 May;51(3):427-31. doi: 10.3349/ymj.2010.51.3.427.
The objective of this study is to evaluate the continence rate following reconstruction of the posterior urethral plate in robot-assisted laparoscopic radical prostatectomy (RLRP).
A retrospective analysis of 50 men with clinically localized prostate cancer who underwent RLRP was carried out. Twenty-five patients underwent RLRP using the reconstruction of the posterior aspect of the rhabdosphincter (Rocco repair). Results of 25 consecutive patients who underwent RLRP prior to the implementation of the Rocco repair were used as the control. Continence was assessed at 7, 30, 90, and 180 days following foley catheter removal using the EPIC questionnaire as well as a follow-up interview with the surgeon.
There was no statistically significant difference between the two groups in any of the patient demographics. At 7 days, the Rocco experimental group had a continence rate of 19% vs. 38.1% in the non-Rocco control group (p = 0.306). At 30 days, the continence rate in the Rocco group was 76.2% vs. 71.4% in the non-Rocco group (p = 1). At 90 days, the values were 88% vs. 80% (p = 0.718), respectively. At 180 days, the pad-free rate was 96% in both groups.
Rocco repair offers no significant advantage in the time to recovery of continence following RLRP when continence is defined as the use of zero pads per day. On the other hand, Rocco repair was associated with increased incidence of urinary retention requiring prolonged foley catheter placement.
本研究旨在评估机器人辅助腹腔镜前列腺根治性切除术（RLRP）中重建后尿道板的控尿率。
对 50 例接受 RLRP 治疗的局限性前列腺癌患者进行回顾性分析。25 例患者采用重建逼尿肌后腹（Rocco 修复）进行 RLRP。将 Rocco 修复前连续 25 例接受 RLRP 的患者的结果作为对照。在拔除 Foley 导管后 7、30、90 和 180 天，使用 EPIC 问卷以及与外科医生的随访访谈评估控尿情况。
两组患者的任何人口统计学特征均无统计学差异。在 7 天时，Rocco 实验组的控尿率为 19%，而非 Rocco 对照组为 38.1%（p=0.306）。在 30 天时，Rocco 组的控尿率为 76.2%，而非 Rocco 组为 71.4%（p=1）。在 90 天时，相应的数值分别为 88%和 80%（p=0.718）。在 180 天时，两组的无尿垫率均为 96%。
当控尿定义为每天使用零尿垫时，Rocco 修复在 RLRP 后恢复控尿的时间上没有显著优势。另一方面，Rocco 修复与留置 Foley 导管时间延长导致尿潴留的发生率增加有关。
