Ferrandino Michael N, Espino Gustavo, Young Marcos, Bodden Elías, Gahan Jeffrey C
Colorado Urology, Westminster, Colorado, USA.
Robotic Surgery Center, Hospital Nacional, Panama City, Panama.
Urol Int. 2024;108(6):574-577. doi: 10.1159/000540739. Epub 2024 Aug 5.
Stress urinary incontinence (SUI) is a frequent, known complication following robot-assisted radical prostatectomy (RARP) for prostate cancer. Urethral shortening and reduced urethral support following RARP are contributing factors.
Herein, we describe a surgical approach using a novel absorbable urologic scaffold to mitigate SUI in 2 patients enrolled in an ongoing single-arm prospective study. The scaffold is designed to relieve the burden on the urinary sphincter by lengthening the effective urethra following RARP. The scaffold is placed at the anastomotic site, overlying the bladder neck and urethral stump following prostate removal and prior to the creation of the anastomosis. Both patients successfully underwent the prostatectomy and urologic scaffold placement with no reported perioperative complications. Neither patient suffered from early SUI following RARP as measured by pad weight and usage at 1 and 3 months following the procedure.
Early experience with the absorbable urologic scaffold suggests it could safely and effectively prevent SUI following RARP. Early and long-term results derived from the ongoing prospective study with this device will better define its potential role in the prevention of SUI.
压力性尿失禁（SUI）是前列腺癌机器人辅助根治性前列腺切除术（RARP）后常见的已知并发症。RARP后尿道缩短和尿道支撑力降低是促成因素。
在此，我们描述了一种手术方法，使用一种新型可吸收泌尿外科支架来减轻2例参与正在进行的单臂前瞻性研究患者的SUI。该支架旨在通过延长RARP后的有效尿道来减轻尿道括约肌的负担。该支架放置在吻合部位，在切除前列腺后、吻合之前覆盖膀胱颈和尿道残端。两名患者均成功接受了前列腺切除术和泌尿外科支架置入，未报告围手术期并发症。根据术后1个月和3个月时的尿垫重量和使用情况测量，两名患者在RARP后均未出现早期SUI。
可吸收泌尿外科支架的早期经验表明，它可以安全有效地预防RARP后的SUI。来自该设备正在进行的前瞻性研究的早期和长期结果将更好地确定其在预防SUI中的潜在作用。
