Autologous retro-pubic urethral sling

A novel, quick, intra-operative technique to improve continence after robotic-assisted radical prostatectomy

Sanoj Punnen, K. Clinton Cary, Allison S. Glass, Janet E. Cowan, Peter R. Carroll

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

After radical prostatectomy, many men may suffer from urinary incontinence, which can have detrimental effects on quality of life. We describe a novel technique using an autologous retro-pubic urethral sling placed at the time of robotic-assisted laparoscopic prostatectomy (RALP) and evaluate its impact on post-operative urinary continence. During 2011, 153 men who underwent sling placement at the time of RALP at a high-volume academic institution were compared to 78 men who did not undergo sling placement. The primary outcomes were time to one and no pads per day. The association between these outcomes and placement of a sling was assessed using Cox proportional hazards regression. Median follow-up was 26 weeks in those who had slings and 32.5 weeks in those who did not. Clinical and pathological characteristics were similar between the groups, with the exception that sling patients were older (p <0.01) and underwent less nerve sparing (p <0.01). Multivariate analysis showed that sling placement did not appear to have an effect on time to one (p = 0.24) or no pads per day (p = 0.20). Although the association between sling placement and early return of urinary continence did not reach statistical significance, there was a selection bias against the sling, since it was placed in men who were expected to have more difficulty regaining their continence. A randomized trial is needed to assess the true benefit of sling placement on urinary continence.

Original languageEnglish (US)
Pages (from-to)99-104
Number of pages6
JournalJournal of Robotic Surgery
Volume8
Issue number2
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Suburethral Slings
Robotics
Prostatectomy
Selection Bias
Urinary Incontinence
Multivariate Analysis
Quality of Life

Keywords

  • Autologous
  • Incontinence
  • Retro-pubic sling
  • Robotic-assisted radical prostatectomy

ASJC Scopus subject areas

  • Surgery
  • Health Informatics

Cite this

Autologous retro-pubic urethral sling : A novel, quick, intra-operative technique to improve continence after robotic-assisted radical prostatectomy. / Punnen, Sanoj; Cary, K. Clinton; Glass, Allison S.; Cowan, Janet E.; Carroll, Peter R.

In: Journal of Robotic Surgery, Vol. 8, No. 2, 2014, p. 99-104.

Research output: Contribution to journalArticle

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