Evaluation Of Urinary Continence Recovery after Nerve-sparing Versus Non-nerve-sparing Robot-Assisted Radical Prostatectomy. | ||
| Egyptian Journal of Urology | ||
| Articles in Press, Accepted Manuscript, Available Online from 18 March 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/eju.2025.364500.1026 | ||
| Authors | ||
| Ahmed Assem* 1; Ashraf Mesharafa2; Omar Mohamed3; Mohamed Abo El Kheer4; Ashraf Emran5 | ||
| 1Urology department, kasr Alainy School of Medicine, Cairo University | ||
| 2department of urology, Faculty of Medicine, Cairo university | ||
| 3Urology department, Faculty of Medicine, Cairo university | ||
| 4Urology department, Southend-on-Sea University hospitals, UK | ||
| 5Urology department, Faculty of Medicine, Cairo university. | ||
| Abstract | ||
| Introduction: Radical prostatectomy is one of the most common treatment options for organ-confined prostate cancer. One of the major adverse events is post-prostatectomy urinary incontinence. The aim of the study is to evaluate the impact of nerve sparing surgery on urinary continence recovery. Methods: This study is a retrospective comparative study in which patients with localized/locally advanced Prostate Cancer treated with robot-assisted radical prostatectomy (RARP) were included. Patients were classified into three groups: 1) Non-Nerve Sparing (NNS), 2) Unilateral NS, and 3) Bilateral NS RARP. Preoperative demographic and oncological data were recorded. Urinary continence was assessed using Epic-26 (short form) validated questionnaire preoperatively as well as at 6-weeks, 3-months, 6-months, 9-months, and 12-months postoperatively. Results: Our study included 205 patients: 101 NNS, 62 unilateral NS, and 42 bilateral NS. On comparing the continence scores during the first two follow-ups (6-weeks and 3-momths), there was a statistically significant difference between the bilateral NS and NNS groups. In the 6-weeks follow-up, the median continence score was 209 vs. 125 (P value 0.002), and in the 3-months follow-up, the median continence score was 292 vs. 184 (P value 0.015). No statistically significant differences in continence were noted at 6M, 9M, and 12M. There was a statistically significant difference in comparing time to zero pad with a median value of 6 weeks vs. 3 months (P value 0.024). Conclusion: Nerve-sparing surgery significantly contributes to the early postoperative recovery of urinary continence, although it may be associated with a higher risk of positive surgical margin. | ||
| Keywords | ||
| Robotic prostatectomy; urinary continence; erectile function | ||
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