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- Title
Improved early continence following laparoscopic radical prostatectomy: the urethral hammock technique.
- Authors
Ortner, Gernot; Honis, Hanne-Rose; Böhm, Julia; Konschake, Marko; Tokas, Theodoros; Nagele, Udo
- Abstract
Purpose: To introduce and illustrate a novel urethral reconstruction technique—the ‘urethral hammock-technique’—and to assess its impact on early postoperative continence following laparoscopic radical prostatectomy (LRP). Methods: 119 patients who underwent LRP between January 2020 and May 2022 (hammock group: n = 43, control group: n = 76) were included in the study. The primary outcome was continence (zero pads or max. one security pad) at 1, 3, and 6 months following surgery. Secondary outcomes were operative time, complications, and histological findings. Univariate and multivariate regression analyses were performed to reveal predictors for continence. p values < 0.05 with a two-sided 95%-confidence interval were considered statistically significant. Results: Baseline characteristics were comparable among both groups. The number of patients achieving complete continence in both the hammock and control groups at various time intervals was: 4 weeks 37.2% (16/43) vs. 19.2% (14/73) (p = 0.047); 3 months 60.5% (26/43) vs. 37.3% (28/75) (p = 0.021) and 6 months 72.1% (31/43) vs. 60.3% (44/73) (p = 0.23), respectively. Adjusting for bladder neck preservation status and age, the hammock technique was a significant predictor for continence for the 4-week (OR 0.33, 95% CI 0.13–0.83, p = 0.019) and 3-month (OR 0.28, 95% CI 0.12–0.66, p = 0.004) interval but not for the 6-month interval (OR 0.64, 95% CI 0.27–1.5, p = 0.31). Operative time, complication rates, time till catheter extraction and histological findings were comparable between both groups (all p > 0.05). Conclusions: The hammock technique is a simple and reproducible technique to improve early postoperative continence for at least 3 months following surgery. However, these promising results warrant confirmation through a randomized controlled trial.
- Publication
World Journal of Urology, 2024, Vol 42, Issue 1, p1
- ISSN
0724-4983
- Publication type
Article
- DOI
10.1007/s00345-024-04857-x