로봇 보조 전립선절제술에서 요도후벽재건술이 조기 요자제 회복에 미치는 영향
Effect of Posterior Urethral Reconstruction (PUR) in Early Recovery of Urinary Continence after Robotic-Assisted Radical Prostatectomy
김수동, 김태효, 조재욱, 성경탁, 유윤철,
소속 상세정보
김수동 ( Kim Soo-Dong )
동아대학교 의과대학 비뇨기과학교실
김태효 ( Kim Tae-Hyo )
동아대학교 의과대학 비뇨기과학교실
조재욱 ( Cho Jae-Wook )
동아대학교 의과대학 비뇨기과학교실
성경탁 ( Sung Gyung-Tak )
동아대학교 의과대학 비뇨기과학교실
유윤철 ( You Youn-Chul )
동아대학교 의과대학 비뇨기과학교실
KMID : 0358320090500121203
Abstract
Purpose: Prolonged urinary incontinence is one of the greatest concerns for patients undergoing radical prostatectomy. One of the possible causes for this urinary incontinence is a postoperative deficiency of the external striated urethral sphincter (EUS) complex and continence nerves. We evaluated the effect of posterior urethral reconstruction (PUR) in the early recovery of urinary continence after robotic-assisted radical prostatectomy.
Materials and Methods: Between January 2008 and March 2009 we performed robotic-assisted radical prostatectomy with PUR in 30 patients (PUR group) and without PUR in 30 patients (non-PUR group). We compared perioperative parameters and postoperative continence rates between the two groups. Continence was defined as no pads or one diaper per 24 hours and was assessed 1 month, 3 months, and 6 months after the procedure.
Results: Patients in the PUR group achieved better continence rates at 1 month (43% vs. 35%) and 3 months of follow-up (89% vs. 64%). At 6 months of follow-up, the continence rate was similar between the two groups (96% vs. 90%). No major complications were observed in the PUR group. However, 2 cases of anastomotic site leakage and 1 case of delayed bleeding were observed in the non-PUR group.
Conclusions: Posterior urethral reconstruction appears to be an easy and reproducible technique in robotic-assisted radical prostatectomy. Our early experience demonstrates that PUR in robotic-assisted radical prostatectomy appears to confer early continence recovery and reduce intraoperative complications.
키워드
Robotics;Prostatectomy;Urinary incontinence
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