Abstract：
Background and Objectives: To evaluate the efficacy of bladder-prostatic muscle reconstruction and bladder neck eversion anastomosis in the recovery of urinary continence after robot-assisted radical prostatectomy (RARP). Materials and Methods: From January 2020 to May 2022, 69 patients who underwent RARP in our hospital were recruited. Thirty-seven patients underwent RARP with the Veil of Aphrodite technique (control group). On the basis of the control group, 32 patients underwent bladder-prostatic muscle reconstruction and bladder neck eversion anastomosis during RARP (observation group). The recovery of urinary continence was followed up at 24 h and 1, 4, 12, and 24 weeks after catheter removal. Results: There were no significant differences in operative time (127.76 ± 21.23 min vs. 118.85 ± 24.71 min), blood loss (118.27 ± 16.75 mL vs. 110.77 ± 19.63 mL), rate of leakage (3.13% vs. 2.70%), rate of positive surgical margin (6.25% vs. 10.81%), or postoperative Gleason score [7 (6−8) vs. 7 (7−8)] between the observation group and the control group (p > 0.05). After catheter removal, the rates of urinary continence at 24 h, 1 week, 4 weeks, 12 weeks, and 24 weeks were 46.88%, 68.75%, 84.38%, 90.63%, and 93.75% in the observation group, respectively. Meanwhile, the rates of urinary continence in the control group were 21.62%, 37.84%, 62.16%, 86.49%, and 91.89%, respectively. There was a significant difference between the two groups (p = 0.034), especially at 24 h, 1 week, and 4 weeks after catheter removal (p < 0.05). Conclusions: Bladder-prostatic muscle reconstruction and bladder neck eversion anastomosis were beneficial to the recovery of urinary continence after RARP, especially early urinary continence.
摘要：
背景与目的:评价膀胱-前列腺肌重建术和膀胱颈外翻吻合术在机器人辅助前列腺癌根治术(RARP)后尿失禁恢复中的疗效。材料与方法：2020年1月至2022年5月，收集了69例在我院接受RARP的患者。37例患者接受了阿芙罗狄蒂面纱技术的RARP（对照组）。在对照组的基础上,32例患者行膀胱-前列腺肌重建术及膀胱颈外翻吻合术(观察组)。在拔除导管后24h和1、4、12和24周随访尿失禁的恢复。结果：手术时间无明显差异（127.76±21.23minvs.118.85±24.71分钟),失血量（118.27±16.75mLvs.110.77±19.63mL),泄漏率(3.13%vs.2.70%），切缘阳性率（6.25%vs.10.81%），或术后Gleason评分[7（6-8）vs.7(7-8)]观察组与对照组比较(p>0.05)。拔除导管后,24小时尿失禁的发生率，1周,4周,12周,24周为46.88%，68.75%,84.38%，90.63%,观察组为93.75%,分别。同时,对照组尿失禁发生率为21.62%,37.84%,62.16%，86.49%，和91.89%，分别。两组有显著性差异(p=0.034),特别是在24小时，1周,拔除导管后4周(p<0.05)。结论:膀胱-前列腺肌重建术和膀胱颈外翻吻合术有利于RARP术后尿失禁的恢复。尤其是早期尿失禁。
