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Surgery

Retzius-sparing RARP improves continence recovery

Nature Reviews Urology volume 14, page 390 (2017)Cite this article

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Most men undergoing robot-assisted radical prostatectomy (RARP) using the anterior approach eventually obtain urinary continence at 1 year after catheter removal; however, only around 50% are continent at 1 week. Now, data from a randomized-controlled trial indicate superior short-term continence-recovery outcomes following use of a posterior, Retzius-sparing approach.

A total of 120 patients with low-risk or intermediate-risk prostate cancer were randomized to receive either anterior or posterior RARP, with a primary outcome of urinary continence at 1 week after catheter removal. 48% of men who underwent anterior RARP were continent at 1 week after catheter removal, versus 71% of men undergoing the posterior procedure (P = 0.01), with a median time to continence recovery of 8 and 2 days, respectively. This statistically significant improvement in continence was retained at 1, 2 and 3 months after surgery (P = 0.02). Furthermore, the incidence of postoperative complications did not differ significantly between groups. The authors attributed these positive outcomes obtained with the posterior approach to better preservation of the bladder neck, while also sparing the space of the Retzius.

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References

  1. Dalela, D. et al. A pragmatic randomized controlled trial examining the impact of the retzius-sparing approach on early urinary continence recovery after robot-assisted radical prostatectomy. Eur. Urol. http://dx.doi.org/10.1016/j.eururo.2017.04.029 (2017)

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  1. Peter Sidaway
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Cite this article

Sidaway, P. Retzius-sparing RARP improves continence recovery. Nat Rev Urol 14, 390 (2017). https://doi.org/10.1038/nrurol.2017.79

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