Retzius-sparing vs. posterior urethral suspension: similar early-phase post-robotic radical prostatectomy continence outcomes

Abstract

Abstract Introduction Stress urinary incontinence (SUI) is a risk of robotic-assisted radical prostatectomy (RP) that can be a frustrating problem for both surgeons and patients. We aim to compare short term continence outcomes between patients undergoing Retzius Sparing RP (RS-RP) and those undergoing standard RP with inclusion of a PUS suture technique and suprapubic tube (PUS-RP). Materials and Methods A retrospective review of 105 consecutive patients who underwent RP was performed, comparing patients who underwent RS-RP and PUS-RP. Our main outcome was pad usage as a surrogate for SUI. Patients were evaluated 4 weeks following RP and again at approximately 3 months. Continence was defined as no pad usage or up to one safety pad per day. Risk factors associated with not being continent were identified using univariate and multivariate analyses. Results In our cohort, 52 patients underwent RS-RP and 53 patients underwent PUS-RP. The two groups had similar patient demographics. Although not statistically significant, there was a higher rate of a positive surgical margin in the RS-RP compared to PUS-RP (25% vs 15%, p = 0.204). At one month follow up for PUS-RP and RS-RP, there was no significant difference in frequency of continent men (69.2% vs. 76.9%, p = 0.302). At 3 month follow up for the two groups of patients, again, there was no significant difference in frequency of continence for PUS-RP and RS-RP (86.2% vs 88%, p = 0.824). Conclusion Patients who underwent RS-RP had similar rates of continence to those patients undergoing PUS-RP in the short term post-operative period.