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Retzius Sparing Robot-Assisted Radical Prostatectomy Conveys Early Regain of Continence over Conventional Robot-Assisted Radical Prostatectomy: A Propensity Score Matched Analysis of 1,863 Patients

 Jongsoo Lee  ;  Ha Yan Kim  ;  Hyeok Joon Goh  ;  Ji Eun Heo  ;  Ahmad Almujalhem  ;  Ali A Alqahtani  ;  Doo Yong Chung  ;  Kidon Chang  ;  Young Deuk Choi  ;  Koon Ho Rha 
 JOURNAL OF UROLOGY, Vol.203(1) : 137-144, 2020-01 
Journal Title
Issue Date
Aged ; Erectile Dysfunction / physiopathology ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Postoperative Complications / physiopathology* ; Propensity Score ; Prostatectomy / methods* ; Prostatic Neoplasms / pathology ; Prostatic Neoplasms / surgery* ; Quality of Life ; Recovery of Function ; Robotic Surgical Procedures / methods* ; Urinary Incontinence / physiopathology*
organ sparing treatments ; prostatectomy ; prostatic neoplasms ; robotic surgical procedures ; urinary incontinence
Purpose: We compared early continence recovery after surgical treatment of prostate cancer with Retzius sparing robot-assisted radical prostatectomy and conventional robot-assisted radical prostatectomy.

Materials and methods: Robot-assisted radical prostatectomy was done by a single surgeon in 1,863 cases between October 2005 and May 2018 using the conventional and the Retzius sparing technique in 1,150 and 713, respectively. To compare continence outcomes between the groups propensity score matching was performed using 9 preoperative variables, including age, body mass index, prostate specific antigen, biopsy Gleason Grade Group, clinical T stage, prostate volume on transrectal ultrasound, and the I-PSS (International Prostate Symptom Score), I-PSS quality of life score and International Index of Erectile Function-5 scores. Continence was assessed by the pad count every month postoperatively until month 6 and was converted to a binary outcome.

Results: After propensity score matching 609 cases per group were matched with no significant difference in all 9 variables. The Kaplan-Meier curve analysis revealed that Retzius sparing robot-assisted radical prostatectomy was associated with a significantly better continence recovery rate than conventional robot-assisted radical prostatectomy during the 6-month study period (p <0.001).

Conclusions: Based on propensity score matching with multiple variables and a large case series, Retzius sparing robot-assisted radical prostatectomy can be a candidate for future robot-assisted radical prostatectomy. It achieves better early continence recovery, a short operative time and early recovery compared to conventional robot-assisted radical prostatectomy.
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1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ha Yan(김하얀)
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Lee, Jong Soo(이종수) ORCID logo https://orcid.org/0000-0002-9984-1138
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Heo, Ji Eun(허지은) ORCID logo https://orcid.org/0000-0002-4184-8468
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