The September issue of European Urology, the official journal of the European Association of Urology, features an article and a video in the Surgery in Motion section by Vipul R. Patel et al, showing that the periurethral suspension technique results in significantly greater continence rates at 3 months after robot-assisted laparoscopic radical prostatectomy (RALP).

RALP is a widespread and rapidly expanding procedure around the world. Several studies have shown that RALP is feasible with limited blood loss, favourable complication rates, and short hospital times. Also, the continence rates 1 year after RALP reach over 90% in most of the large, single-centre prospective studies - results at least comparable to the open radical retropubic prostatectomy (RRP). However, early urinary incontinence following radical prostatectomy (RP) is still a significant concern for patients with prostate-confined cancer. A variety of surgical techniques have been used in an attempt to improve the early return of continence after RP.

"We describe our technique of periurethral retropubic suspension stitch during RALP and report its impact on early recovery of urinary continence in the European Urology article entitled 'Periurethral Suspension Stitch During Robot-Assisted Laparoscopic Radical Prostatectomy: Description of the Technique and Continence Outcomes'", says Dr Patel.

"We analyse 331 consecutive patients who underwent RALP, 94 without the placement of suspension stitch (group 1) and 237 with the application of the suspension stitch (group 2)".

The suspension technique resulted in significantly greater continence rates at 3 months after RALP. The median/mean interval to recovery of continence was also statistically significantly shorter in the suspension group. Continence was defined as the use of no absorbent pads or no leakage of urine.

Periurethral Suspension Stitch During Robot-Assisted Laparoscopic Radical Prostatectomy: Description of the Technique and Continence Outcomes
Vipul R. Patel, Rafael F. Coelho, Kenneth J. Palmer, Bernardo Rocco
Accepted 8 June 2009, Published online 16 June 2009, pages 472 - 478

Source:
Lindy Brouwer
European Association of Urology