Journal of Yeungnam Medical Science

Original article

Association between cystographic anastomotic urinary leakage following retropubic radical prostatectomy and early urinary incontinence: Se Yun Kwon; Yeungnam Univ J Med. 2021;38(2):142-147. Published online November 19, 2020; DOI: https://doi.org/10.12701/yujm.2020.00682

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Background
This study was performed to investigate the association between cystographic anastomotic urinary leakage (UL) after radical retropubic prostatectomy (RRP) and early urinary incontinence (UI).
Methods
The medical records of 53 patients who had undergone cystography after RRP at our institution between January 2015 and December 2018 were retrospectively analyzed. Cystography was performed 7 to 10 days after surgery. The duration of catheterization depended on the degree of UL, which was classified as mild, moderate, or severe. The study subjects were divided into the non-UL group and the UL group. Continence was defined as the use of no pads. The prostate was dissected in an antegrade fashion, and urethrovesical anastomosis was performed with a continuous suture.
Results
Incontinence rates at 1 and 3 months postoperatively were significantly higher in the UL group than the non-UL group (83.3% vs. 52.2%, p=0.014 and 76.7% vs. 47.8%, p=0.030, respectively); however, those at 6 and 12 months were not significantly different (23.3% vs. 17.4%, p=0.597 and 4.3% vs. 10.0%, p=0.440, respectively). The presence of cystographic anastomotic UL was found to be predictive of UI during the first 3 postoperative months (odds ratio, 3.3; p=0.045). The continence rates during the first 3 postoperative month continence rate showed significant difference with non-UL group regardless of the degree of UL.
Conclusion
The presence of anastomotic UL on cystography was associated with higher rates of UI in the early postoperative period, however the grade of UL was not related to the late recovery of UI. Incontinence rates in patients with or without anastomotic UL immediately after RRP equalized at 6 months.

Citations

Citations to this article as recorded by

Recognition of Postoperative Cystography Features by Artificial Intelligence to Predict Recovery from Postprostatectomy Urinary Incontinence: A Rapid and Easy Way to Predict Functional Outcome
I-Hung Shao, Hung-Cheng Kan, Hung-Yi Chen, Ying-Hsu Chang, Liang-Kang Huang, Yuan-Cheng Chu, Po-Hung Lin, Kai-Jie Yu, Cheng-Keng Chuang, See-Tong Pang, Chun-Te Wu
Journal of Personalized Medicine.2023; 13(1): 126. CrossRef

Review Article

Functional recovery after radical prostatectomy for prostate cancer: Young Hwii Ko; Yeungnam Univ J Med. 2018;35(2):141-149. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.141

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Abstract PDF

With the enthusiasm regarding robotic application in radical prostatectomy in accordance with the widespread use of serum prostate-specific antigen as a screening test, the number of surgeries performed for complete removal of the gland is increasing continuously. However, owing to the adjacent anatomical location of the prostate to the nerve and urethral sphincter complex, functional recovery, namely improvement from post-prostatectomy incontinence (PPI) and post-prostatectomy erectile dysfunction, still remains a main problem for patients who are reluctant to undergo surgery and tend to choose alternative ways instead. Since the late 1980s, the introduction of radical prostatectomy by open surgical modalities, the depth of the anatomical understanding of the structure surrounding the prostate is getting tremendous, which leads to the development of new surgical modalities and techniques that are consequently aimed at reducing the incidences of PPI and erectile dysfunction. Briefly, recent data from robotic radical prostatectomy, particularly on PPI, are quite acceptable, but by contrast, the reported potency regain rate still remains <20%, which indicates the need for advanced surgical modification to overcome it. In this review, the authors summarized the recent findings on the anatomy and surgical techniques reported up to now.

Citations

Citations to this article as recorded by

The assessment of erectile dysfunction after radical prostatectomy using pudendal somatosensory evoked potential
Se Yun Kwon, Jin-Mo Park, Appuwawadu Mestri Nipun Lakshitha de Silva
PLOS ONE.2023; 18(11): e0292847. CrossRef
Fidgetin-like 2 negatively regulates axonal growth and can be targeted to promote functional nerve regeneration
Lisa Baker, Moses Tar, Adam H. Kramer, Guillermo A. Villegas, Rabab A. Charafeddine, Olga Vafaeva, Parimala Nacharaju, Joel Friedman, Kelvin P. Davies, David J. Sharp
JCI Insight.2021;[Epub] CrossRef

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