Korean J Urol.  2013 Sep;54(9):598-602.

Comparison of Continence Recovery Between Robot-Assisted Laparoscopic Prostatectomy and Open Radical Retropubic Prostatectomy: A Single Surgeon Experience

• Son SJ
• Lee SC
• Jeong CW
• Jeong SJ
• Byun SS
• Lee SE

Abstract

PURPOSE
To evaluate the recovery of continence after robot-assisted laparoscopic prostatectomy (RALP) and open radical retropubic prostatectomy (RRP).
MATERIALS AND METHODS
We identified 258 patients who underwent surgery by a single surgeon to treat localized prostate cancer. The patients were divided into two groups according to operative method. In group 1, 146 consecutive patients underwent RALP, and in group 2, 112 patients underwent RRP. To compare the interval until the return of urinary continence between the two groups, we used the Kaplan-Meier method and the log-rank test and Cox proportional hazard regression analyses.
RESULTS
Differences between the two groups were found in mean estimated blood loss (EBL; p<0.001) and the rate of nerve sparing (p=0.004). When continence was defined as the use of 0 to 1 pad per day, 100% of group 1 and 98.2% of group 2 reported continence at 12 months (p=0.189). When continence was defined as no pad use, however, there was a significant difference between the two groups at 12 months: group 1, 95.7%, and group 2, 70.7% (p<0.001). The factors affecting time until no pad use in the univariate analysis with a Cox proportional hazards model were operation method, age, neurovascular bundle saving, membranous urethral length (MUL), EBL, and apical shape. In the multivariate analysis, only operation method, age, and MUL retained significance.
CONCLUSIONS
Our study suggests that RALP is an independent factor for the recovery of continence and that RALP has advantages for postoperative continence recovery and the quality of continence compared with RRP.

Keyword

Prostate neoplasms; Prostatectomy; Robotics; Urinary incontinence

MeSH Terms

Humans
Multivariate Analysis
Proportional Hazards Models
Prostatectomy
Prostatic Neoplasms
Robotics
Urinary Incontinence

Figure

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  FIG. 1 Continent rate after surgery. (A) When continence was defined as no pad or a single secure pad requirement per day. (B) When continence was defined as no pad use. RALP, robot-assisted laparoscopic prostatectomy; RRP, radical retropubic prostatectomy.*Chi-square test.

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