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World Journal of Urology

Erschienen in:

15.10.2019 | Original Article

Advanced Reconstruction of Vesicourethral Support (ARVUS) during robot-assisted radical prostatectomy: first independent evaluation and review of other factors influencing 1 year continence outcomes

verfasst von: Viktor Kováčik, Matúš Maciak, Vladimír Baláž, Jozef Babeľa, Viliam Kubas, Peter Bujdák, Peter Beňo

Erschienen in: World Journal of Urology | Ausgabe 8/2020

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Abstract

Purpose

Anterior and posterior reconstructions of pelvic structures are used during a robot-assisted radical prostatectomy to obtain better continence outcomes. This study was conducted to evaluate the Advanced Reconstruction of Vesicourethral Support (ARVUS), a novel postprostatectomy reconstruction technique.

Methods

The study was designed as a prospective, controlled, partially randomized and blinded experiment. The statistical analysis was based on the generalized linear modeling (GLM) framework with random effects: the logit link was used to model the probability of achieving continence and the logarithmic link was used to evaluate the overall score of the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). The significance of the fixed effects and all possible two-way interactions was tested using the critical level of 0.05.

Results

The probability of achieving the continence significantly depends on the neurovascular bundle sparing (p < 0.001) and the time after the surgery (p < 0.001). Analogously, the expected ICIQ-SF score significantly depends on the nerve-sparing status (p = 0.035) and the time after the surgery (p < 0.001). No statistically significant difference between the unilateral or bilateral nerve sparing was found. The ARVUS technique seems to perform slightly worse with respect to the expected continence, but this difference is within the margins of random fluctuations (p = 0.715).

Conclusions

The study demonstrates a significant positive association between the nerve-sparing approach and the patient’s continence, however, regardless of the unilateral or bilateral approach. In terms of the continence rate, no statistically significant benefits of ARVUS were observed.

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Titel: Advanced Reconstruction of Vesicourethral Support (ARVUS) during robot-assisted radical prostatectomy: first independent evaluation and review of other factors influencing 1 year continence outcomes
verfasst von: Viktor Kováčik
Matúš Maciak
Vladimír Baláž
Jozef Babeľa
Viliam Kubas
Peter Bujdák
Peter Beňo
Publikationsdatum: 15.10.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 8/2020
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-019-02975-5

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