[Two-layer posterior reconstruction of the vesicourethral anastomosis during robotic-assisted radical prostatectomy].

AIM

To study the influence of the technique of posterior reconstruction of the vesicourethral anastomosis (VUA) on the prevention of urinary incontinence after robotic-assisted radical prostatectomy (RARP).

MATERIAL AND METHODS

A total of 67 patients (mean age 63 years) with localized prostate cancer were included in the study. All patients were divided into two groups. In the group 1 (n=32) the standard technique of the VUA was used, while in the group 2 (n=35) the two-layer posterior reconstruction was done. The impact of urinary incontinence on the quality of life was analyzed using the ICIQ-SF questionnaire 1, 3 and 6 months after operation. On postoperative days 5-7, all patients underwent cystography to assess the tightness of the VUA.

RESULTS

One month after RARP in the group 1 the mean score of ICIQ-SF questionnaire was 6.72, compared to 4.57 in group 2 (p=0.04). After 3 and 6 months the respective values were 3.8 vs. 2.3 (p=0.09) and 1.94 vs. 1.2 (p=0.23), respectively. Cystography revealed no extravasation of the contrast.

CONCLUSION

The results of a retrospective comparative study suggest that a two-layer posterior reconstruction of the VUA during RARP, being a simple method, provides better continence rate one month postoperatively compared to standard technique, although larger randomized clinical trials are needed.