Comparison Of Early Urinary Control After Robot-assisted Laparoscopic Radical Prostatectomy With Conventional Surgery Plus Retropubic Urethral Suspension Surgery

Objective:Radical prostatectomy is the gold standard for the treatment of early and mid-stage localized prostate cancer.The incidence of urinary incontinence is relatively high among postoperative complications.How to address postoperative urinary incontinence has always been the focus of improving the quality of life of patients.In recent years,posterior pubic urethral suspension has been used as a new adjuvant treatment and has been gradually used in the treatment of postoperative urinary incontinence.However,The efficacy of posterior pubic urethral suspension still controversial.This article aims to evaluate the effectiveness of posterior pubic urethral suspension in improving early urinary control after radical prostatectomy,to determine whether it is worthy of promotion in clinical work.Methods:Retrospectively collected and analyzed the clinical data of 50patients who underwent Robot-assisted radical prostatectomy in XX Hospital from February 2016 to August 2020.All the patients had clear preoperative examination and were early and mid-stage localized prostate cancer.Among them,24 cases underwent Robot-assisted laparoscopic radical prostatectomy and 26 cases underwent Robot-assisted laparoscopic radical prostatectomy plus posterior pubic urethral suspension.The preoperative data(Prostate-specific antigen,PSA),age,BMI,prostate volume,puncture pathology Gleason score,TNM staging),intraoperative data(operation duration,intraoperative blood loss),and postoperative data(surgical complications,biochemical recurrence,positive surgical margin PSM,pathological staging)and other indicators were compared between the two groups of patients.Through the evaluation of daily diaper usage(using 0-1 changing pads a day to basically return to normal urinary control),the differences in early postoperative urinary control between the two groups of patients were compared.Statistical analysis was performed using statistical software SPSS25.0.Normally distributed measurement data was expressed as mean±standard deviation(x±s),and comparison between groups was performed by t-test;count data was expressed as frequency and percentage(%).The chi-square(χ~2)test was used for the inter-comparison,and the difference was statistically significant at P<0.05.Results:There was no significant difference in clinical data such as age,BMI,PSA,prostate volume,and Gleason score between the two groups of patients.Both groups successfully completed the operation.The Robot-assisted laparoscopic radical prostatectomy plus posterior pubic urethral sling group was superior to Robot-assisted laparoscopic radical prostatectomy in the early postoperative period.There was no statistical difference between the two groups in bleeding during the operation and perioperative period blood transfusion rate,gastrointestinal function recovery time,drainage tube indwelling time,positive rate of resection margin,postoperative complications,and postoperative biochemical recurrence.Conclusion:Robot-assisted laparoscopic conventional radical prostatectomy plus urethral sling can improve the patient’s early urinary control rate.