PDF(Pubmed)
Abstract：
UNASSIGNED: Bladder neck contracture and vesicourethral anastomotic stenosis are difficult to manage endoscopically, and open repair is associated with high rates of incontinence. In recent years, there have been increasing reports of robotic-assisted bladder neck reconstruction in the literature. However, existing studies are small, heterogeneous case series. The objective of this study was to perform a systematic review of robotic-assisted bladder neck reconstruction to better evaluate patency and incontinence outcomes.
UNASSIGNED: We performed a systematic review of PubMed from first available date to May 2023 for all studies evaluating robotic-assisted reconstructive surgery of the bladder neck in adult men. Articles in non-English, author replies, editorials, pediatric-based studies, and reviews were excluded. Outcomes of interest were patency and incontinence rates, which were pooled when appropriate.
UNASSIGNED: After identifying 158 articles on initial search, we included only ten studies that fit all aforementioned criteria for robotic-assisted bladder neck reconstruction. All were case series published from March 2018 to March 2022 ranging from six to 32 men, with the median follow-up of 5-23 months. A total of 119 patients were included in our analysis. A variety of etiologies and surgical techniques were described. Patency rates ranged from 50% to 100%, and pooled patency was 80% (95/119). De novo incontinence rates ranged from 0% to 33%, and pooled incontinence was 17% (8/47). Our findings were limited by small sample sizes, relatively short follow-ups, and heterogeneity between studies.
UNASSIGNED: Despite limitations, current available evidence suggests comparable patency outcomes and improved incontinence outcomes for robotic bladder neck reconstruction compared to open repair. Additional prospective studies with longer-term follow-ups are needed to confirm these findings.
UNASSIGNED: We performed a systematic review of PubMed from first available date to May 2023 for all studies evaluating robotic-assisted reconstructive surgery of the bladder neck in adult men. Articles in non-English, author replies, editorials, pediatric-based studies, and reviews were excluded. Outcomes of interest were patency and incontinence rates, which were pooled when appropriate.
UNASSIGNED: After identifying 158 articles on initial search, we included only ten studies that fit all aforementioned criteria for robotic-assisted bladder neck reconstruction. All were case series published from March 2018 to March 2022 ranging from six to 32 men, with the median follow-up of 5-23 months. A total of 119 patients were included in our analysis. A variety of etiologies and surgical techniques were described. Patency rates ranged from 50% to 100%, and pooled patency was 80% (95/119). De novo incontinence rates ranged from 0% to 33%, and pooled incontinence was 17% (8/47). Our findings were limited by small sample sizes, relatively short follow-ups, and heterogeneity between studies.
UNASSIGNED: Despite limitations, current available evidence suggests comparable patency outcomes and improved incontinence outcomes for robotic bladder neck reconstruction compared to open repair. Additional prospective studies with longer-term follow-ups are needed to confirm these findings.
摘要：
■膀胱颈挛缩和膀胱尿道吻合口狭窄难以通过内窥镜检查进行处理，开放式修复与尿失禁的高发生率有关。近年来,文献中越来越多的机器人辅助膀胱颈重建术的报道.然而,现有的研究规模很小，异质案例系列。这项研究的目的是对机器人辅助膀胱颈重建进行系统评价，以更好地评估通畅性和尿失禁的结果。
■我们从第一个可用日期到2023年5月对所有评估成年男性膀胱颈机器人辅助重建手术的研究进行了系统评价。非英语文章，作者答复,社论,以儿科为基础的研究，和评论被排除在外。感兴趣的结果是通畅率和失禁率，在适当的时候汇集。
■在初始搜索中识别出158篇文章后，我们仅纳入了10项符合上述机器人辅助膀胱颈重建术标准的研究.所有病例均为2018年3月至2022年3月发布的病例系列，涉及6至32名男性，中位随访时间为5-23个月。共有119名患者被纳入我们的分析。描述了各种病因和手术技术。专利率从50%到100%不等,合并通畅率为80%(95/119)。从头失禁发生率从0%到33%不等,汇集性尿失禁占17％（8/47）。我们的发现受到小样本量的限制，相对较短的随访，和研究之间的异质性。
■尽管有限制，现有证据表明,与开放修复相比,机器人膀胱颈重建术的通畅性结局和失禁结局改善相当.需要进行更长期随访的其他前瞻性研究来证实这些发现。
■我们从第一个可用日期到2023年5月对所有评估成年男性膀胱颈机器人辅助重建手术的研究进行了系统评价。非英语文章，作者答复,社论,以儿科为基础的研究，和评论被排除在外。感兴趣的结果是通畅率和失禁率，在适当的时候汇集。
■在初始搜索中识别出158篇文章后，我们仅纳入了10项符合上述机器人辅助膀胱颈重建术标准的研究.所有病例均为2018年3月至2022年3月发布的病例系列，涉及6至32名男性，中位随访时间为5-23个月。共有119名患者被纳入我们的分析。描述了各种病因和手术技术。专利率从50%到100%不等,合并通畅率为80%(95/119)。从头失禁发生率从0%到33%不等,汇集性尿失禁占17％（8/47）。我们的发现受到小样本量的限制，相对较短的随访，和研究之间的异质性。
■尽管有限制，现有证据表明,与开放修复相比,机器人膀胱颈重建术的通畅性结局和失禁结局改善相当.需要进行更长期随访的其他前瞻性研究来证实这些发现。
