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World Journal of Surgical Oncology
Published in: World Journal of Surgical Oncology 1/2017

Open Access 01-12-2017 | Research

The efficacy and feasibility of total reconstruction versus nontotal reconstruction of the pelvic floor on short-term and long-term urinary continence rates after radical prostatectomy: a meta-analysis

Authors: Yu-Peng Wu, Ning Xu, Shi-Tao Wang, Shao-Hao Chen, Yun-Zhi Lin, Xiao-Dong Li, Qing-Shui Zheng, Yong Wei, Xue-Yi Xue

Published in: World Journal of Surgical Oncology | Issue 1/2017

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Abstract

Background

Recently, total pelvic floor reconstruction (TR) has been the treatment of choice for improving urinary incontinence (UI) after radical prostatectomy (RP). However, the superiority of TR with respect to urinary continence recovery following RP remains controversial. This study identified the effect of TR versus nonTR of the pelvic floor on short-term and long-term continence rates after RP.

Methods

A literature search was performed in November 2017 using the PubMed, Embase, and Web of Science databases. Only comparative research or clinical studies reporting urinary continence outcomes was included in the meta-analysis, and the quality of evidence was evaluated using the 2011 Level of Evidence for therapy research.

Results

We analyzed ten studies reporting urinary continence rates after RP at one or more postoperative time points (1, 2, 4, 12, 24, and 52 weeks). TR was associated with significantly better urinary continence outcomes at 1 week (OR 2.76, 95% CI 1.58–4.84, P < 0.001), 2 weeks (OR 2.57, 95% CI 1.74–3.80, P < 0.001), 4 weeks (OR 2.61, 95% CI 1.56–4.38, P < 0.001), 12 weeks (OR 4.33, 95% CI 2.01–9.33, P < 0.001), 24 weeks (OR 3.83, 95% CI 1.54–9.55, P = 0.004), 52 weeks (OR 4.10, 95% CI 1.80–9.38, P < 0.001) after RP. There was no difference in the rate of complications between the two arms (OR 0.54, 95% CI 0.19–1.54, P = 0.25).

Conclusions

Compared with nonTR, TR is significantly and positively associated with a return to continence but not with complication rate in men following RP, suggesting that TR may be useful for decreasing the urinary incontinence rate after surgery.
Literature
1.
Wu YP, Lin TT, Chen SH, Xu N, Wei Y, Huang JB, Sun XL, Zheng QS, Xue XY, Li XD. Comparison of the efficacy and feasibility of en bloc transurethral resection of bladder tumor versus conventional transurethral resection of bladder tumor: a meta-analysis. Medicine (Baltimore). 2016;95:e5372.CrossRef
2.
Cornford P, Bellmunt J, Bolla M, Briers E, De Santis M, Gross T, Henry AM, Joniau S, Lam TB, Mason MD, et al. EAU-ESTRO-SIOG guidelines on prostate cancer. Part II: treatment of relapsing, metastatic, and castration-resistant prostate cancer. Eur Urol. 2016;71:630–42.
3.
Ficarra V, Novara G, Artibani W, Cestari A, Galfano A, Graefen M, Guazzoni G, Guillonneau B, Menon M, Montorsi F, et al. Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a systematic review and cumulative analysis of comparative studies. Eur Urol. 2009;55:1037–63.CrossRefPubMed
4.
Menon M, Shrivastava A, Kaul S, Badani KK, Fumo M, Bhandari M, Peabody JO. Vattikuti Institute prostatectomy: contemporary technique and analysis of results. Eur Urol. 2007;51:648–57.CrossRefPubMed
5.
Sanda MG, Dunn RL, Michalski J, Sandler HM, Northouse L, Hembroff L, Lin X, Greenfield TK, Litwin MS, Saigal CS, et al. Quality of life and satisfaction with outcome among prostate-cancer survivors. N Engl J Med. 2008;358:1250–61.
6.
Jonler M, Madsen FA, Rhodes PR, Sall M, Messing EM, Bruskewitz RC. A prospective study of quantification of urinary incontinence and quality of life in patients undergoing radical retropubic prostatectomy. Urology. 1996;48:433–40.CrossRefPubMed
7.
Mungovan SF, Sandhu JS, Akin O, Smart NA, Graham PL, Patel MI. Preoperative membranous urethral length measurement and continence recovery following radical prostatectomy: a systematic review and meta-analysis. Eur Urol. 2016;71:368–78.
8.
Hoshi A, Usui Y, Shimizu Y, Tomonaga T, Kawakami M, Nakajima N, Hanai K, Nomoto T, Terachi T. Dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy. Int J Urol. 2013;20:493–500.CrossRefPubMed
9.
Stolzenburg JU, Rabenalt R, Do M, Schwalenberg T, Winkler M, Dietel A, Liatsikos E. Intrafascial nerve-sparing endoscopic extraperitoneal radical prostatectomy. Eur Urol. 2008;53:931–40.CrossRefPubMed
10.
Hoshi A, Nitta M, Shimizu Y, Higure T, Kawakami M, Nakajima N, Hanai K, Nomoto T, Usui Y, Terachi T. Total pelvic floor reconstruction during non-nerve-sparing laparoscopic radical prostatectomy: impact on early recovery of urinary continence. Int J Urol. 2014;21:1132–7.CrossRefPubMed
11.
Stolzenburg JU, Liatsikos EN, Rabenalt R, Do M, Sakelaropoulos G, Horn LC, Truss MC. Nerve sparing endoscopic extraperitoneal radical prostatectomy—effect of puboprostatic ligament preservation on early continence and positive margins. Eur Urol. 2006;49:103–11. discussion 111–102
12.
Patel VR, Coelho RF, Palmer KJ, Rocco B. Periurethral suspension stitch during robot-assisted laparoscopic radical prostatectomy: description of the technique and continence outcomes. Eur Urol. 2009;56:472–8.
13.
Porpiglia F, Fiori C, Grande S, Morra I, Scarpa RM. Selective versus standard ligature of the deep venous complex during laparoscopic radical prostatectomy: effects on continence, blood loss, and margin status. Eur Urol. 2009;55:1377–83.CrossRefPubMed
14.
Joshi N, de Blok W, van Muilekom E, van der Poel H. Impact of posterior musculofascial reconstruction on early continence after robot-assisted laparoscopic radical prostatectomy: results of a prospective parallel group trial. Eur Urol. 2010;58:84–9.CrossRefPubMed
15.
Nguyen MM, Kamoi K, Stein RJ, Aron M, Hafron JM, Turna B, Myers RP, Gill IS. Early continence outcomes of posterior musculofascial plate reconstruction during robotic and laparoscopic prostatectomy. BJU Int. 2008;101:1135–9.CrossRefPubMed
16.
Rocco B, Gregori A, Stener S, Santoro L, Bozzola A, Galli S, Knez R, Scieri F, Scaburri A, Gaboardi F. Posterior reconstruction of the rhabdosphincter allows a rapid recovery of continence after transperitoneal videolaparoscopic radical prostatectomy. Eur Urol. 2007;51:996–1003.CrossRefPubMed
17.
Coelho RF, Chauhan S, Orvieto MA, Sivaraman A, Palmer KJ, Coughlin G, Patel VR. Influence of modified posterior reconstruction of the rhabdosphincter on early recovery of continence and anastomotic leakage rates after robot-assisted radical prostatectomy. Eur Urol. 2011;59:72–80.CrossRefPubMed
18.
Tewari A, Jhaveri J, Rao S, Yadav R, Bartsch G, Te A, Ioffe E, Pineda M, Mudaliar S, Nguyen L, et al. Total reconstruction of the vesico-urethral junction. BJU Int. 2008;101:871–7.CrossRefPubMed
19.
Liao X, Qiao P, Tan Z, Shi H, Xing N. “Total reconstruction” of the urethrovesical anastomosis contributes to early urinary continence in laparoscopic radical prostatectomy. Int Braz J Urol. 2016;42:215–22.CrossRefPubMedPubMedCentral
20.
Hurtes X, Roupret M, Vaessen C, Pereira H, Faivre d'Arcier B, Cormier L, Bruyere F. Anterior suspension combined with posterior reconstruction during robot-assisted laparoscopic prostatectomy improves early return of urinary continence: a prospective randomized multicentre trial. BJU Int. 2012;110:875–83.
21.
Koliakos N, Mottrie A, Buffi N, De Naeyer G, Willemsen P, Fonteyne E. Posterior and anterior fixation of the urethra during robotic prostatectomy improves early continence rates. Scand J Urol Nephrol. 2010;44:5–10.CrossRefPubMed
22.
Menon M, Muhletaler F, Campos M, Peabody JO. Assessment of early continence after reconstruction of the periprostatic tissues in patients undergoing computer assisted (robotic) prostatectomy: results of a 2 group parallel randomized controlled trial. J Urol. 2008;180:1018–23.CrossRefPubMed
23.
Sammon JD, Muhletaler F, Peabody JO, Diaz-Insua M, Satyanaryana R, Menon M. Long-term functional urinary outcomes comparing single- vs double-layer urethrovesical anastomosis: two-year follow-up of a two-group parallel randomized controlled trial. Urology. 2010;76:1102–7.CrossRefPubMed
24.
Liu W, Galik E, Boltz M, Nahm ES, Resnick B. Optimizing eating performance for older adults with dementia living in long-term care: a systematic review. Worldviews Evid-Based Nurs. 2015;12:228–35.
25.
Atug F, Kural AR, Tufek I, Srivastav S, Akpinar H. Anterior and posterior reconstruction technique and its impact on early return of continence after robot-assisted radical prostatectomy. J Endourol. 2012;26:381–6.CrossRefPubMed
26.
Tan G, Srivastava A, Grover S, Peters D, Dorsey P Jr, Scott A, Jhaveri J, Tilki D, Te A, Tewari A. Optimizing vesicourethral anastomosis healing after robot-assisted laparoscopic radical prostatectomy: lessons learned from three techniques in 1900 patients. J Endourol. 2010;24:1975–83.CrossRefPubMed
27.
Student V Jr, Vidlar A, Grepl M, Hartmann I, Buresova E, Student V. Advanced reconstruction of vesicourethral support (ARVUS) during robot-assisted radical prostatectomy: one-year functional outcomes in a two-group randomised controlled trial. Eur Urol. 2017;71:822–30.CrossRefPubMed
28.
Ficarra V, Novara G, Rosen RC, Artibani W, Carroll PR, Costello A, Menon M, Montorsi F, Patel VR, Stolzenburg JU, et al. Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. Eur Urol. 2012;62:405–17.CrossRefPubMed
Metadata
Title
The efficacy and feasibility of total reconstruction versus nontotal reconstruction of the pelvic floor on short-term and long-term urinary continence rates after radical prostatectomy: a meta-analysis
Authors
Yu-Peng Wu
Ning Xu
Shi-Tao Wang
Shao-Hao Chen
Yun-Zhi Lin
Xiao-Dong Li
Qing-Shui Zheng
Yong Wei
Xue-Yi Xue
Publication date
01-12-2017
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2017
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-017-1296-z

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