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Advanced Reconstruction of Vesicourethral Support (ARVUS) during robot-assisted radical prostatectomy: first independent evaluation and review of other factors influencing 1 year continence outcomes
V. Kováčik, M. Maciak, V. Baláž, J. Babeľa, V. Kubas, P. Bujdák, P. Beňo
Language English Country Germany
Document type Journal Article, Randomized Controlled Trial
NLK
ProQuest Central
from 1997-02-01 to 1 year ago
Medline Complete (EBSCOhost)
from 2000-02-01 to 1 year ago
Health & Medicine (ProQuest)
from 1997-02-01 to 1 year ago
- MeSH
- Anastomosis, Surgical methods MeSH
- Time Factors MeSH
- Urinary Incontinence epidemiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Urinary Bladder surgery MeSH
- Prostatic Neoplasms surgery MeSH
- Postoperative Complications epidemiology MeSH
- Prospective Studies MeSH
- Prostatectomy methods MeSH
- Robotic Surgical Procedures * MeSH
- Aged MeSH
- Urethra surgery MeSH
- Urologic Surgical Procedures methods MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Publication type
- Journal Article MeSH
- Randomized Controlled Trial MeSH
PURPOSE: Anterior and posterior reconstructions of pelvic structures are used during a robot-assisted radical prostatectomy to obtain better continence outcomes. This study was conducted to evaluate the Advanced Reconstruction of Vesicourethral Support (ARVUS), a novel postprostatectomy reconstruction technique. METHODS: The study was designed as a prospective, controlled, partially randomized and blinded experiment. The statistical analysis was based on the generalized linear modeling (GLM) framework with random effects: the logit link was used to model the probability of achieving continence and the logarithmic link was used to evaluate the overall score of the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). The significance of the fixed effects and all possible two-way interactions was tested using the critical level of 0.05. RESULTS: The probability of achieving the continence significantly depends on the neurovascular bundle sparing (p < 0.001) and the time after the surgery (p < 0.001). Analogously, the expected ICIQ-SF score significantly depends on the nerve-sparing status (p = 0.035) and the time after the surgery (p < 0.001). No statistically significant difference between the unilateral or bilateral nerve sparing was found. The ARVUS technique seems to perform slightly worse with respect to the expected continence, but this difference is within the margins of random fluctuations (p = 0.715). CONCLUSIONS: The study demonstrates a significant positive association between the nerve-sparing approach and the patient's continence, however, regardless of the unilateral or bilateral approach. In terms of the continence rate, no statistically significant benefits of ARVUS were observed.
2nd Urology department of Slovak Medical University F D Roosevelt hospital Banská Bystrica Slovakia
Department of Vascular Surgery Central Military and Faculty Hospital Ružomberok Slovakia
Faculty of Medicine Comenius University in Bratislava Bratislava Slovakia
Faculty of Medicine Slovak Medical University Bratislava Slovakia
References provided by Crossref.org
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- $a PURPOSE: Anterior and posterior reconstructions of pelvic structures are used during a robot-assisted radical prostatectomy to obtain better continence outcomes. This study was conducted to evaluate the Advanced Reconstruction of Vesicourethral Support (ARVUS), a novel postprostatectomy reconstruction technique. METHODS: The study was designed as a prospective, controlled, partially randomized and blinded experiment. The statistical analysis was based on the generalized linear modeling (GLM) framework with random effects: the logit link was used to model the probability of achieving continence and the logarithmic link was used to evaluate the overall score of the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). The significance of the fixed effects and all possible two-way interactions was tested using the critical level of 0.05. RESULTS: The probability of achieving the continence significantly depends on the neurovascular bundle sparing (p < 0.001) and the time after the surgery (p < 0.001). Analogously, the expected ICIQ-SF score significantly depends on the nerve-sparing status (p = 0.035) and the time after the surgery (p < 0.001). No statistically significant difference between the unilateral or bilateral nerve sparing was found. The ARVUS technique seems to perform slightly worse with respect to the expected continence, but this difference is within the margins of random fluctuations (p = 0.715). CONCLUSIONS: The study demonstrates a significant positive association between the nerve-sparing approach and the patient's continence, however, regardless of the unilateral or bilateral approach. In terms of the continence rate, no statistically significant benefits of ARVUS were observed.
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