Anterior reconstruction after radical prostatectomy

Abstract

When treating localised prostate cancer, excellent oncological outcomes with low rate of complications are nowadays possible with radical prostatectomy (RP) (Bill-Axelson et al., N Engl J Med 364:1708-1717, 2011; Novara et al., Eur Urol 62:382-404, 2012). However, functional outcomes in terms of continence and potency recovery are still less enthusiastic. Indeed, in patients who do not early recover continence quality of everyday life is markedly reduced, especially in younger and more active ones (Sanda et al., N Engl J Med 358:1250-1261, 2008). The proportion of continent patients at one year after surgery ranges from 70% to 100% in the available Literature (Fig. 34.1) (Ficarra et al., Eur Urol 62:405-417, 2012). Such disparities in the literature are probably due to either non-homogeneous definition of continence or measurement methods (questionnaires, number of pads, pad test). Several factors have been identified as leading to, including patient characteristics (body mass index, age, prostate volume, and comorbidities), experience of the surgeon, and surgical precision (Ahlering et al., Curr Urol Rep 14:52-58, 2013). Prospective and retrospective studies comparing different robot-assisted radical prostatectomy surgical techniques. From the Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy by Ficarra et al. Eur Urol. 2012;62:405-17.