Effect of Reconstructive Techniques on Continence in Robot-Assisted Laparoscopic Prostatectomy: Long Urethral Stump and Anterior Suspension Suture; New Combined Technique

Objective: To investigate the effects of the novel combination of a long urethral stump and anterior suspension suture in patients who underwent Robot-Assisted Laparoscopic Prostatectomy (RALP) for localized prostate cancer. Materials and Methods: Of the 40 participating patients, 20 did not undergo any reconstructive technique, whereas the remaining 20 patients underwent reconstructive technique that included the combination of long urethral stump and anterior suspension suture. Body mass index (BMI) (kg/m(2)), age, preoperative prostate-specific antigen (PSA) levels, prostate volume, Gleason score, D'Amico risk class, clinical stage, operation type and the application of either perioperative or postoperative reconstructive techniques, and the duration of catheterization were the parameters investigated. Continence rate was measured in the 3(rd), 6(th), and 12(th) month after the removal of the catheter. Both techniques were compared statistically. Results: The control and reconstructive groups each comprised 20 patients. Between the groups, no statistically significant differences were observed in age, BMI, American Society of Anesthesiologists class, risk group, prostate weight, perioperative PSA, duration of surgery, duration of hospitalization, surgical margins, and the total amount of bleeding (p>0.05). Continence rate was significantly higher in the reconstructive group in the 3(rd) and 6(th) months compared with the control group (p<0.05). Conclusion: The combination of anterior suspension suture and long urethral stump contributed to early improvement in the continence rates.