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Prospective evaluation of vesicourethral anastomosis outcomes in robotic radical prostatectomy during early experience in a university hospital

PURPOSE: Robotic assisted radical prostatectomy (RARP) presents challenges for the surgeon, especially during the initial learning curve. We aimed to evaluate early and mid-term functional outcomes and complications related to vesicourethral anastomosis (VUA), in patients who underwent RARP, during...

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Autores principales: Burttet, Lucas Medeiros, Varaschin, Gabrielle Aguiar, Berger, Andre Kives, Cavazzola, Leandro Totti, Berger, Milton, Silva, Brasil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Urologia 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734083/
https://www.ncbi.nlm.nih.gov/pubmed/28727367
http://dx.doi.org/10.1590/S1677-5538.IBJU.2016.0466
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author Burttet, Lucas Medeiros
Varaschin, Gabrielle Aguiar
Berger, Andre Kives
Cavazzola, Leandro Totti
Berger, Milton
Silva, Brasil
author_facet Burttet, Lucas Medeiros
Varaschin, Gabrielle Aguiar
Berger, Andre Kives
Cavazzola, Leandro Totti
Berger, Milton
Silva, Brasil
author_sort Burttet, Lucas Medeiros
collection PubMed
description PURPOSE: Robotic assisted radical prostatectomy (RARP) presents challenges for the surgeon, especially during the initial learning curve. We aimed to evaluate early and mid-term functional outcomes and complications related to vesicourethral anastomosis (VUA), in patients who underwent RARP, during the initial experience in an academic hospital. We also assessed possible predictors of postoperative incontinence and compared these results with the literature. MATERIALS AND METHODS: We prospectively collected data from consecutive patients that underwent RARP. Patients with at least 6 months of follow-up were included in the analysis for the following outcomes: time to complete VUA, continence and complications related to anastomosis. Nerve-sparing status, age, BMI, EBL, pathological tumor staging, and prostate size were evaluated as possible factors predicting early and midterm continence. Results were compared with current literature. RESULTS: Data from 60 patients was assessed. Mean time to complete VUA was 34 minutes, and console time was 247 minutes. Continence in 6 months was 90%. Incidence of urinary leakage was 3.3%, no patients developed bladder neck contracture or postoperative urinary retention. On multivariate analysis, age and pathological staging was associated to 3-month continence status. CONCLUSION: Our data show that, during early experience with RARP in a public university hospital, it is possible to achieve good results regarding continence and other outcomes related to VUA. We also found that age and pathological staging was associated to early continence status.
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spelling pubmed-57340832017-12-19 Prospective evaluation of vesicourethral anastomosis outcomes in robotic radical prostatectomy during early experience in a university hospital Burttet, Lucas Medeiros Varaschin, Gabrielle Aguiar Berger, Andre Kives Cavazzola, Leandro Totti Berger, Milton Silva, Brasil Int Braz J Urol Surgical Technique PURPOSE: Robotic assisted radical prostatectomy (RARP) presents challenges for the surgeon, especially during the initial learning curve. We aimed to evaluate early and mid-term functional outcomes and complications related to vesicourethral anastomosis (VUA), in patients who underwent RARP, during the initial experience in an academic hospital. We also assessed possible predictors of postoperative incontinence and compared these results with the literature. MATERIALS AND METHODS: We prospectively collected data from consecutive patients that underwent RARP. Patients with at least 6 months of follow-up were included in the analysis for the following outcomes: time to complete VUA, continence and complications related to anastomosis. Nerve-sparing status, age, BMI, EBL, pathological tumor staging, and prostate size were evaluated as possible factors predicting early and midterm continence. Results were compared with current literature. RESULTS: Data from 60 patients was assessed. Mean time to complete VUA was 34 minutes, and console time was 247 minutes. Continence in 6 months was 90%. Incidence of urinary leakage was 3.3%, no patients developed bladder neck contracture or postoperative urinary retention. On multivariate analysis, age and pathological staging was associated to 3-month continence status. CONCLUSION: Our data show that, during early experience with RARP in a public university hospital, it is possible to achieve good results regarding continence and other outcomes related to VUA. We also found that age and pathological staging was associated to early continence status. Sociedade Brasileira de Urologia 2017 /pmc/articles/PMC5734083/ /pubmed/28727367 http://dx.doi.org/10.1590/S1677-5538.IBJU.2016.0466 Text en https://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Surgical Technique
Burttet, Lucas Medeiros
Varaschin, Gabrielle Aguiar
Berger, Andre Kives
Cavazzola, Leandro Totti
Berger, Milton
Silva, Brasil
Prospective evaluation of vesicourethral anastomosis outcomes in robotic radical prostatectomy during early experience in a university hospital
title Prospective evaluation of vesicourethral anastomosis outcomes in robotic radical prostatectomy during early experience in a university hospital
title_full Prospective evaluation of vesicourethral anastomosis outcomes in robotic radical prostatectomy during early experience in a university hospital
title_fullStr Prospective evaluation of vesicourethral anastomosis outcomes in robotic radical prostatectomy during early experience in a university hospital
title_full_unstemmed Prospective evaluation of vesicourethral anastomosis outcomes in robotic radical prostatectomy during early experience in a university hospital
title_short Prospective evaluation of vesicourethral anastomosis outcomes in robotic radical prostatectomy during early experience in a university hospital
title_sort prospective evaluation of vesicourethral anastomosis outcomes in robotic radical prostatectomy during early experience in a university hospital
topic Surgical Technique
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734083/
https://www.ncbi.nlm.nih.gov/pubmed/28727367
http://dx.doi.org/10.1590/S1677-5538.IBJU.2016.0466
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