Efficacy of modified pelvic floor reconstruction in non-nerve-sparing robot-assisted radical prostatectomy
10.3969/j.issn.1009-8291.2025.12.004
- VernacularTitle:改良盆底重建在非神经保留机器人辅助前列腺癌根治术中的应用效果
- Author:
Xuexing FAN
1
;
Gen LI
1
;
Jincheng LI
1
;
Jiasong LI
1
;
Yuhao YU
2
;
Pugui LI
1
;
Xiaopeng CHEN
1
;
Zhiguo LU
1
;
Geng ZHANG
1
;
Yong WANG
1
Author Information
1. Department of Urology, Tangdu Hospital, Fourth Military Medical University, X'i an 710038
2. Department of Urology, Xi'an Daxing Hospital, Xi'an 710082, China
- Publication Type:Journal Article
- Keywords:
robot-assisted radical prostatectomy;
non-nerve-sparing;
urinary continence;
pelvic floor reconstruction
- From:
Journal of Modern Urology
2025;30(12):1038-1042,1063
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and safety of modified pelvic floor reconstruction in non-nerve-sparing robot-assisted radical prostatectomy (NNS RARP) for improving postoperative urinary control. Methods A retrospective analysis was conducted on the clinical data of 79 prostate cancer patients who underwent NNS RARP at Tangdu Hospital during Jan.2020 and Dec.2023, including 29 in the reconstruction group, and 50 in the non-reconstruction group. The baseline characteristics including age, body mass index, prostate-specific antigen (PSA) level, clinical stage, prostate volume, and biopsy Gleason score, and perioperative indexes including operation time, intraoperative blood loss, catheter indwelling time, complication rate, and positive rate of surgical margins were compared between the two groups. Additionally, urinary continence function was assessed before operation and 1,3,6, and 12 months after operation using the international consultation on incontinence questionnaire-short form (ICIQ-SF) and the incontinence quality of life questionnaire score (I-QoL). Results No statistically significant differences were observed in the baseline characteristics between the two groups (P>0.05). The operation time was significantly longer in the reconstruction group than in the non-reconstruction group [ (110.24±15.08) min vs. (101.80±9.89) min, P=0.010]. There were no significant differences in intraoperative blood loss, catheter indwelling time, complication rate, and positive rate of surgical margins between the two groups (P>0.05). The reconstruction group demonstrated significantly lower ICIQ-SF scores at 1 month [ (10.17±2.16) vs. (11.56±1.66), P=0.002],3 months [ (7.62±1.29) vs. (9.52±1.80), P<0.001], and 6 months postoperatively [ (4.93±1.22) vs. (6.18± 1.67), P=0.001]compared to the non-reconstruction group (adjusted P<0.0125). Conversely, the I-QoL scores were significantly higher in the reconstruction group at 1 month [ (73.32±10.30) vs. (63.88±9.55), P<0.001]and 3 months postoperatively [ (78.91±4.82) vs. (75.66±5.17), P=0.007] (adjusted P<0.0125). However, no significant differences were found in ICIQ-SF or I-QoL scores between the two groups preoperatively and 12 months postoperatively (adjusted P>0.0125). Conclusion The application of modified pelvic floor reconstruction technique in NNS RARP is safe and feasible. Although it slightly prolongs the operation time, it does not increase surgical risks; instead, it effectively promotes early recovery of postoperative urinary continence, thereby significantly enhancing patients'quality of life.
