Methods of urinary continence maintenance after robot-assisted prostatectomy: a literature review

Robot-assisted radical prostatectomy provides positive functional results after surgery and helps to achieve urinary continence and maintain quality of life. At the same time, further development of new surgical methods and approaches is being carried out, which will let improve this characteristic. And although robot-assisted radical prostatectomy, according the data, recently published systematic reviews and meta-analyses, has demonstrated a higher level of postoperative urinary continence in comparison with radical retropubic prostatectomy, urinary incontinence remains one of the most common postoperative complications. The present review summarizes modern literature data on the effectiveness of the available methods of urinary continence maintenance. The information content of the predictors of the possibility of urinary continence recovery is also reviewed. The main concept of achieving urinary continence implicates that the integrity of normal anatomical and functional structures should be maintained. Three steps should be followed in order to achieve early recovery of urinary retention after robot-assisted prostatectomy: maintenance, recovery and strengthening of anatomical structures. The present analysis indicates that all currently applied surgical procedures aimed at providing urinary continence are more likely to affect the time of urination recovery, while the results for urinary continence obtained after a year of monitoring do not depend on the technique applied. A unique predictor in the evaluation of the probability of postoperative urinary continence recovery is patient’s age. Conducting multicentre research with continuous time of monitoring is promising for the evaluation of the effectiveness of different methods of urinary continence maintenance after robot-assisted prostatectomy.