Restoration of urine retention after robotic-assisted radical prostatectomy with Retzius space preservation

Introduction. Robot-assisted radical prostatectomy, due to its low morbidity and high precision technique, is rapidly taking a leading position among the methods of treatment of localized prostate cancer. At the same time, the requirements for functional results of this surgery are steadily increasing, which encourages the improvement of its technique. Urinary incontinence after prostatectomy significantly reduces the quality of life of the patient and refers to its socially significant consequences. Objective. To conduct a comparative assessment of the restoration of urine retention after a robot-assisted nerve-sparing radical prostatectomy using a standard surgery and after the use of technique with Retzius space preservation. Materials and methods. We conducted prospective analysis of the urine continence recovery in 54 patients who underwent nerve-sparing robot-assisted radical prostatectomy in the Clinic of urology and surgical andrology of the Russian medical academy of continuous medical education (in the urological department of the S.P. Botkin state clinical hospital) in the period from 2017 to 2018. Depending on the surgical technique used, the patients divided into two groups. The first group included 29 patients who were undergone a surgery with preservation of the Retzius space. The second group consisted of 25 patients operated according to the standard procedure. Results. In the group with the use of the Retzius space preservation technique, urine retention was achieved at an earlier time and was observed in more patients compared to the group in which the standard technique was used. This trend continued throughout the entire follow-up period (54.13% vs 41.81%; 68.12% vs 59.21%; 94.15% vs 90.63%; 98.54% vs 97.12%; 98.62% vs 97.31%; 98.83% vs 97.82%- a week after removal of the urethral catheter, as well as 1, 3, 6, 9 and 12 months after the surgery in the first and second groups, respectively). Conclusions. Nerve-sparing robot-assisted radical prostatectomy with preservation of the Retinal space outperforms the standard technique in terms of urinary continence restoration.