Background
Study ID | Puboprostatic ligaments | Pubovesical collar | Arcus tendineus | Rhabdosphincter | Denonvillier’s fascia | Bladder neck | Median dorsal raphe |
---|---|---|---|---|---|---|---|
Student [27], 2017 | + | – | + | + | + | + | + |
Liao [19], 2016 | + | – | + | + | + | + | + |
Atug [25], 2012 | – | – | – | + | + | + | – |
Hoshi [10], 2014 | + | – | – | + | + | + | + |
Hurtes [20], 2012 | + | – | – | + | + | – | + |
Menon [22], 2008 | + | + | – | + | + | – | + |
Tewari [18], 2007 | + | – | + | + | + | + | + |
Koliakos [21], 2009 | + | – | – | – | + | + | + |
Tan [26], 2010 | + | – | + | + | + | + | + |
Sammon [23], 2010 | + | + | – | + | + | – | – |
Methods
Ethics statement and objective
Search strategy
Study selection
Inclusion criteria | Exclusion criteria |
---|---|
Men undergoing RP | Review articles and descriptive commentaries |
Studies reporting TR versus nonTR | Animal studies |
Postoperative continence assessment completed | Conference abstracts or poster publications |
English language | Published in a language other than English |
Full journal article publication in a peer-reviewed journal |
Quality assessment
Data extraction and synthesis
Meta-analysis methods
Results
Literature search
Quality assessment
Characteristics of the studies included
Patient and surgical characteristics
Study ID | Country | Method | Sample | Age*, year | Prostate volume*, mL | IIEF-5 score, median (IQR) | IPSS | BMI* (kg/m2) | Preoperative PSA*, ng/mL | Nerve-sparing procedure, n (%) | |||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Bilateral | Unilateral | Non | |||||||||||
Student [27], 2017 | Czech Republic | RARP | T | 32 | 64.5 (56.0–67.0) | 35.0 (30.0–55.0) | 19.0 (13.5–21.0) | 5.5 (2.0–9.3) | 27.7 (25.7–33.2) | 7.3 (5.2–11.2) | 20 (62.5) | 6 (18.75) | 6 (18.75) |
N | 34 | 62.5 (61.0–68.0) | 32.5 (22.0–52.0) | 17.0 (13.3–21.0) | 5.0 (2.8–14.0) | 28.0 (25.4–31.4) | 5.7 (3.6–12.0) | 23 (67.6) | 5 (14.7) | 6 (17.6) | |||
Liao [19], 2016 | China | LRP | T | 82 | 65.79 ± 7.27 | 42.06 ± 19.34*
| – | 7 (0~18) | 24.26 ± 2.88 | 33.07 ± 40.65 | 27 (32.92) | 19 (23.17) | 36 (43.90) |
N | 79 | 67.88 ± 6.65*
| 41.92 ± 14.76*
| – | 6 (0~19) | 25.35 ± 2.13 | 26.86 ± 31.95 | 16 (20.25) | 28 (35.4) | 35 (44.3) | |||
Atug [25], 2012 | Turkey | RARP | T | 125 | 61.5 (9.5) | 50 (24) | – | – | 27 (4) | 5.62 (3.65) | 89 (71.2) | 21 (16.8) | 15 (12) |
N | 120 | 60.50 (11) | 49.5 (25) | – | – | 28 (4) | 5.49 (2.92) | 93 (77.5) | 22 (18.3) | 5 (4.2) | |||
Hoshi [10], 2014 | Japan | LRP | T | 81 | 65.2 ± 5.6 | – | – | – | – | 9.2 ± 5.7 | – | – | – |
N | 47 | 65.4 ± 4.4 | – | – | – | – | 11.8 ± 9.5 | – | – | – | |||
Hurtes [20], 2012 | France | RARP | T | 39 | 62.5 ± 6.8 | 38.5 (20–90) | 20 (6–25) | 5 (0–16) | 26.3 ± 3.5 | 6.4 (2.7–16.6) | – | – | – |
N | 33 | 62.4 ± 5 | 40 (25–80) | 23 (1–25) | 7 (0–17) | 25.7 ± 3.6 | 7.9 (3.6–23.6) | – | – | – | |||
Standard^
| Veil#
| ||||||||||||
Menon [22], 2008 | America | RARP | T | 59 | – | 45.2*
| – | – | 27.9 | 6.1 | 37 (63) | 22 (37) | – |
N | 57 | – | 63.4*
| – | – | 27.9 | 6.4 | 31 (54) | 26 (46) | – | |||
Tewari [18], 2007 | America | RARP | T | 182 | 61.21 | 50.53 | – | – | 24.98 | 5.76 | – | – | – |
N | 214 | 64.32 | 57.12 | – | – | 28.77 | 6.02 | – | – | – | |||
Koliakos [21], 2009 | Belgium | RARP | T | 23 | 60.96 ± 6.56 | – | – | – | – | 10.43 ± 3.37 | – | – | – |
N | 24 | 61.75 ± 5.96 | – | – | – | – | 10.47 ± 2.22 | – | – | – | |||
Tan [26], 2010 | America | RARP | T | 1383 | 60.3 ± 7.4 | 46 (38–56) | – | 7 (3–12) | 26.77 ± 3.59 | 4.8 (3.7–6.57) | – | – | – |
N | 214 | 59.8 ± 6.6 | 48 (39–63) | – | 6 (2–11.25) | 28.34 ± 5.57 | 4.8 (3.9–6.7) | – | – | – | |||
Standard^
| Veil#
| – | |||||||||||
Sammon [23], 2010 | America | RARP | T | 46 | 59.9 ± 7.4 | – | – | – | 28.3 ± 4.1 | 5.8 ± 66.3 | 23 (21) | 21 (45.7) | – |
N | 50 | 60 ± 7.2 | – | – | – | 28 ± 4.21 | 5.7 ± 3.2 | 27 (54.0) | 23 (46.0) | – |
Study ID | Operative time*, min | Estimated blood loss*, mL | Duration of catheterization*, d | Complications, n (%) | PSM rate (%) | ||
---|---|---|---|---|---|---|---|
Total | pT2 | pT3 | |||||
Student [27], 2017 | 78.0 (63.0–126.0)#
| 145.0 (85.5–234.5) | – | 2 (6.2) | 4 (12.5) | – | – |
76.5 (48.0–130.0)#
| 140.0 (80.0–294.0) | – | 2 (5.8) | 5 (14.7) | – | – | |
Liao [19], 2016 | 147.33 ± 29.89 | 232.63 ± 217.93 | 13.96 ± 2.20 | 36 (43.90) | 13 (15.85) | – | – |
130.81 + 21.66 | 225.42 ± 164.96 | 16.13 ± 16.47 | 35 (44.3) | 10 (12.65) | – | – | |
Atug [25], 2012 | 175(55) | 300 (200) | 7 (0) | – | 115 (92) | – | – |
200(70) | 350 (250) | 7 (1) | – | 110 (91.7) | – | – | |
Hoshi [10], 2014 | 240 (139–575) | 228 (59–1340) | – | 3 (3.7) | 13 (16.0) | 8 (11.8) | 5 (38.5) |
219(160–415) | 236 (55–1875) | – | 4 (8.5) | 8 (17.0) | 3 (7.7) | 5 (62.5) | |
Hurtes [20], 2012 | 200 (100–400) | 300 (100–1100) | 6 (5–40) | 8 (20.5) | 8 (21.1) | – | – |
220 (105–350) | 300 (20–1500) | 7 (5–20) | 6 (18.2) | 4 (12.1) | – | – | |
Menon [22], 2008 | 171 | – | 7 | – | – | – | – |
158 | – | 7 | – | – | – | – | |
Tewari [18], 2007 | 104 | 140 | 7 | – | – | 7 (4.8) | – |
132 | 150 | <7 | – | – | 7 (3.8) | – | |
Koliakos [21], 2009 | 126.52 ± 11.48 | 225.65 ± 80.95 | 6.26 ± 0.96 | – | – | – | – |
124.54 ± 10.78 | 224.17 ± 64.06 | 6.17 ± 1.88 | – | – | – | – | |
Tan [26], 2010 | 180 (150–230) | 140 (140–150) | – | 11 (0.8%) | – | 65 (5.7) | – |
187 (160–240) | 150 (150–162.5) | – | 13 (6.0%) | – | 6 (3.2) | – | |
Sammon [23], 2010 | 174.1 ± 38.4 | – | 7.7 ± 2.4 | – | – | – | – |
165.2 ± 36 | – | 9.2 ± 4.2 | – | – | – | – |
Study ID | Clinical stage | Pathological stage | Gleason biopsy, n (%) | Gleason score, n (%) | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
cT1 | cT2 | cT3 | pT0 | pT1 | pT2 | pT3 | < 7 | 7 | > 7 | < 7 | 7 | > 7 | ||
Student [27], 2017 | T 32 | – | – | – | – | – | 20 (62.5) | 12 (37.5) | – | – | – | – | – | – |
N 34 | – | – | – | – | – | 23 (67.6) | 11 (32.4) | – | – | – | – | – | – | |
Liao [19], 2016 | T 82 | – | – | – | 3 (3.7) | 53 (64.6) | 26 (31.7) | 0 | – | – | – | 38 (46.3) | 32 (39.0) | 12 (14.6) |
N 79 | – | – | – | 2 (2.5) | 52 (65.8) | 22 (27.8) | 3 (3.8) | – | – | – | 27 (34.2) | 35 (44.3) | 17 (21.5) | |
Atug [25], 2012 | T 125 | – | – | – | – | 104 (82.9) | 19 (15.5) | 2 (1.6) | – | – | – | – | – | – |
N 120 | – | – | – | – | 100 (83.1) | 17 (14.4) | 3 (2.5) | – | – | – | – | – | – | |
Hoshi [10], 2014 | T 81 | 36 (44.4) | 40 (49.4) | 5 (6.2) | – | – | 68 (84.0) | 13 (16.0) | 29 (35.8) | 36 (44.4) | 16 (19.8) | 34 (42.0) | 35 (43.2) | 12 (14.8) |
N 47 | 30 (63.8) | 15 (31.9) | 2 (4.3) | – | – | 39 (83.0) | 8 (17.0) | 20 (42.6) | 21 (44.7) | 6 (12.8) | 15 (31.9) | 26 (55.3) | 6 (12.8) | |
Hurtes [20], 2012 | T 39 | – | – | – | 2 (5.1) | 29 (74.4) | 8 (20.5) | – | 24 (61.5) | 11 (28.2) | 4 (10.3) | 11 (28.2) | 26 (66.7) | 2 (5.1) |
N 33 | – | – | – | 0 | 24 (72.7) | 9 (27.3) | – | 18 (54.6) | 11 (33.3) | 4 (12.1) | 12 (36.4) | 18 (54.5) | 3 (9.1) | |
Tewari [18], 2007 | T 182 | 147 (80.8) | 30 (16.5) | 5 (2.7) | – | 146 (80.28) | 18.77 | 0.46 | – | – | – | – | – | – |
N 214 | 161 (75.2) | 51 (23.8) | 2 (0.9) | – | 186 (87.38) | 11.21 | 0.93 | – | – | – | – | – | – | |
Tan [26], 2010 | T 1383 | 1250 (90.4) | 133 (9.6) | 0 | – | 1147 (82.9) | 236 (17.1) | – | 828 (59.9) | 459 (33.2) | 96 (6.9) | 430 (31.1) | 874 (63.2) | 79 (5.7) |
N 214 | 161 (75.2) | 51 (23.8) | 2 (0.9) | – | 186 (86.9) | 28 (13.1) | – | 156 (72.9) | 48 (22.4) | 10 (4.7) | 102 (47.4) | 100 (46.9) | 12 (5.6) |
Definition of TR
Definition of UI
Outcomes
Study ID | Study design | Continence definition | Data collection | Cases, n
| 1 week | 2 weeks | 4 weeks | 12 weeks | 24 weeks | 52 weeks | |
---|---|---|---|---|---|---|---|---|---|---|---|
Student [27], 2017 | RCT | 0 pad | Validated questionnaire | T | 32 | – | 43.8 | 62.5 | – | 75.0 | – |
N | 34 | – | 11.8 | 14.7 | – | 44.1 | – | ||||
Liao [19], 2016 | Retrospective | No leak, total control, no pad | Validated questionnaire | T | 82 | 13.41 | 32.92 | 65.85 | 81.71 | 90.24 | 95.12 |
N | 79 | 7.59 | 20.25 | 37.97 | 58.22 | 81.01 | 89.87 | ||||
Atug [25], 2012 | Retrospective | 0–1 safety pad | Interview | T | 125 | 71.2 | 72.8 | 80.8 | 84.8 | 86.4 | 91.2 |
N | 120 | 23.33 | 49.1 | 76.6 | 80.8 | 85.83 | 88.33 | ||||
Hoshi [10], 2014 | Retrospective | 0–1 safety pad | Validated questionnaire | T | 81 | – | – | 18.4 | 45.7 | 71.4 | – |
N | 47 | – | – | 4.5 | 26.1 | 46.8 | – | ||||
Hurtes [20], 2012 | RCT | No leak, total control, no pad | Validated questionnaire | T | 39 | – | 5.9 | 26.5 | 45.2 | 65.4 | – |
N | 33 | – | 3.6 | 7.1 | 15.4 | 57.9 | – | ||||
Menon1 [22], 2008 | RCT | 0–1 safety pad | Validated questionnaire | T | 59 | 54 | – | 80 | – | – | – |
N | 57 | 51 | – | 74 | – | – | – | ||||
Menon2 [22], 2008 | RCT | 0 pad | Validated questionnaire | T | 59 | 20 | – | 42 | – | – | – |
N | 57 | 16 | – | 47 | – | – | – | ||||
Tewari [18], 2007 | Prospective | 0–1 safety pad | Validated questionnaire | T | 182 | 38.37 | – | 82.56 | 91.3 | 97.14 | 97.14a
|
N | 214 | 13.15 | – | 35.21 | 50.23 | 61.97 | 82.16 | ||||
Koliakos [21], 2009 | RCT | 0–1 safety pad | Validated questionnaire | T | 23 | – | – | 65 | – | – | – |
N | 24 | – | – | 33 | – | – | – | ||||
Tan [26], 2010 | Prospective | 0–1 safety pad | Validated questionnaire | T | 1383 | 30.8 | – | 70 | 91.7 | 95 | 98 |
N | 214 | 13.1 | – | 35.2 | 50.2 | 61.9 | 82.1 | ||||
Sammon1 [23], 2010 | RCT | 0–1 safety pad | Validated questionnaire | T | 46 | – | – | 42 | – | – | – |
N | 50 | – | – | 47 | – | – | – | ||||
Sammon2 [23], 2010 | RCT | 0 pad | Validated questionnaire | T | 46 | – | – | 80 | – | – | – |
N | 50 | – | – | 74 | – | – | – |