Presented by: Sung Goo Yoon MD
Department of Urology, Korea University College of Medicine, Seoul, Korea

Introduction

Recently, the modified apical dissection (MAD) technique in robot-assisted laparoscopic radical prostatectomy (RARP) has shown excellent functional outcomes but has never been rigorously validated at various institutions. This study aimed to evaluate the effect of MAD on early continence and potency compared with the anterior suspension stitch (SS) technique.

Materials

A total of 100 patients who underwent RARP with SS and 100 who underwent RARP with MAD by a single surgeon were propensity score matched and retrospectively compared for continence and potency recovery at 1 week and 1, 3, 6, 9, and 12 months.

Results

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Continence was reached in 20.6%, 33.3%, 67.2%, 74.1%, 81.1%, and 83.0% of patients in the SS group, compared with 49.2%, 73.3%, 86.8%, 96.6%, 100.0%, and 100.0% in the MAD group at postoperative 1 week and 1, 3, 6, 9, and 12 months, respectively. In the SS group, potency rates were 0.0%, 20.0%, 50.0%, 66.7%, 75.0%, and 83.3%; in the MAD group, the rates were 50.0%, 90.0%, 88.9%, 100.0%, 100.0%, and 100.0%. Recovery of continence was higher in the MAD group within the first 6 months (p=0.005, <0.010, 0.041, 0.016 at 1 week, 1, 3, and 6 months). There were no significant differences in potency recovery rates between the two groups (all p≥0.05).

Conclusion

The MAD technique results in earlier recovery of continence compared with the SS technique.

Funding

This research was supported by the Korea University College of Medicine.

Lead Authors

Seok Ho Kang, MD,PHD
Department of Urology, Korea University College of Medicine, Seoul, Korea

Sung Gu Kang, MD,PHD
Department of Urology, Korea University College of Medicine, Seoul, Korea

Co-Authors

Hwang Jae Young, MD
Department of Urology, Korea University College of Medicine, Seoul, Korea

Seong Woo Yun, MD
Department of Urology, Korea University College of Medicine, Seoul, Korea

Tae Young Park, MD
Department of Urology, Korea University College of Medicine, Seoul, Korea

Chang Wan Hyun, MD
Department of Urology, Korea University College of Medicine, Seoul, Korea

Tae il Noh, MD,PHD
Department of Urology, Korea University College of Medicine, Seoul, Korea