MAAUA: MAAUA 68th Annual Meeting Abstracts - Posterior Reconstruction Prior to Vesicourethral Anastomosis in Patients Undergoing Robot Assisted Laparoscopic Prostatectomy Leads to Earlier Return to Baseline Continence

MAAUA 68th Annual Meeting Abstracts

Posterior Reconstruction Prior to Vesicourethral Anastomosis in Patients Undergoing Robot Assisted Laparoscopic Prostatectomy Leads to Earlier Return to Baseline Continence
James C Brien, *Bethany Barone, Michael D Fabrizio, Joshua Logan, Robert W Given
Eastern Virginia Medical School/Urology of Virginia, Norfolk, VA

INTRODUCTION:
Reapproximation of Denonvilliers fascia adjacent to bladder neck to the rectourethralis,or the Rocco Stitch (RS), has been suggested to improve continence in post prostatectomy patients. We examined the impact of the RS on post-operative urinary outcomes in patients undergoing robotic assisted laparoscopic prostatectomy (RALP).
METHODS:
We identified 168 patients having undergone RALP for prostate cancer between 2006 and 2009 by a single surgeon (RG); 67 undergoing a posterior reconstruction using RS prior to vesicourethral anastomosis. Prospective validated quality of life data was obtained using the RAND-UCLA questionnaire in patients preoperatively (baseline), and post prostatectomy at 3 and 6 months. AUA symptom scores were gathered at identical intervals.
RESULTS:
Seventy-four patients had complete information with 31 patients comprising the RS group. There were no significant differences between groups regarding preoperative characteristics, pathologic stage or nerve sparing status. There were no significant differences in urinary function, urinary bother or AUA symptom score at baseline or at 6-months post prostatectomy between the two groups. However, at 3-month follow up there was a statistically significant improvement in return to baseline parameters relating to
urinary bother (72%, 53%; p=0.008), and urinary function (64%, 50%; p=0.05) in the RS group vs. no RS group. Additionally, the group not undergoing RS had a statistically significant increase in AUA symptom score from baseline vs. the RS group (+3.8, +0.2;
p=0.005).
CONCLUSIONS:
Posterior reconstruction in patients undergoing RALP has a significant impact on early return to baseline parameters relating to urinary bother, urinary function and AUA symptom score.

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