Neoplasms

Urinary Tract, Sexual Organs, and Pregnancy Conditions

All Conditions

Symptoms and General Pathology

Behaviors and Mental Disorders

Prostatic Neoplasms

Urinary Incontinence

Enuresis

Urination Disorders

Urologic Diseases

Urogenital Diseases

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Male Urogenital Diseases

Lower Urinary Tract Symptoms

Urological Manifestations

Vattikuti Urology Institute radical prostatectomy da Vinci Surgical System

Retzius sparing radical prostatectomy da Vinci Surgical System

Robotic assisted laparoscopic radical prostatectomy based on Retzius sparing technique

Retzius sparing radical prostatectomy

Robotic assisted laparoscopic radical prostatectomy based on Vattikuti Urology Institute technique

Vattikuti Urology Institute radical prostatectomy

The da Vinci Surgical System is a sophisticated robotic platform designed to expand the surgeon's capabilities and offer a state-of-the-art minimally invasive option for major surgery.

da Vinci Surgical System

Mani Menon, MD

To assess and compare the short-term post-operative continence recovery rate in two cohorts of men undergoing Robot Assisted Radical Prostatectomy (RARP), each randomized to undergo RARP with Vattikuti Institute technique or Retzius sparing technique.

Traditionally, RARP is performed using a trans-peritoneal technique that pass anteriorly to the bladder. This technique necessitates the dissection and/or manipulation of many structures, which might compromise post-operative urinary continence recovery. These structures include the pubo-prostatic ligament, Santorini plexus, neurovascular bundle, and veil of Aphrodite. Recently, a "Retzius-sparing" technique to perform RARP has beed described. This approach passes posteriorly to the bladder, through the space of Douglas, which should minimize the damaged to the aforementioned structure. Theoretically, the latter technique should improve post-operative urinary continence recovery. However, a randomized comparison between the "traditional" RARP and "Retzius-sparing" RARP is still lacking.

Impact of Robot-assisted Radical Prostatectomy Technique on Short-term Continence Recovery

The Impact of Retzius-sparing Approach for Robot-assisted Laparoscopic Radical Prostatectomy on Short-term Continence Recovery: Randomized Controlled Trial

MSKCC (Memorial Sloan Kettering Cancer Center) STAR questionnaire (symptom tracking and reporting). Score ranges from 0-25, with higher scores indicating better urinary function

SHIM ranges from 0-25 with higher scores indicating better sexual function; a score of \>=22 is normal and \>=17 is considered mild ED

Patients without biochemical evidence of disease recurrence (i.e. postop PSA \>=0.2 ng/mL)

International Prostatic Symptom Score (continuous score from 0-35, higher scores indicating worse urinary function)

Henry Ford Health System

Director, Vattikuti Urology Institute

Vattikuti Urology Institute radical prostatectomy da Vinci Surgical System

Vattikuti Urology Institute radical prostatectomy: Robotic assisted laparoscopic radical prostatectomy based on Vattikuti Urology Institute technique

da Vinci Surgical System: The da Vinci Surgical System is a sophisticated robotic platform designed to expand the surgeon's capabilities and offer a state-of-the-art minimally invasive option for major surgery.

Control Arm

Retzius sparing radical prostatectomy da Vinci Surgical System

Retzius sparing radical prostatectomy: Robotic assisted laparoscopic radical prostatectomy based on Retzius sparing technique

da Vinci Surgical System: The da Vinci Surgical System is a sophisticated robotic platform designed to expand the surgeon's capabilities and offer a state-of-the-art minimally invasive option for major surgery.

Treatment Arm

Total

Age, Continuous

Sex: Female, Male

preoperative prostate specific antigen level

International Prostatic Symptom Score (IPSS) objectively assesses urinary symptoms. It ranges from 0 to 35, with higher scores indicating worse urinary symptoms

preoperative IPSS score

SHIM (Sexual Health Inventory for Men) objectively asses sexual function. It ranges from 0-25, with higher scores indicating better sexual function.

preoperative SHIM score

NCCN (National Comprehensive Cancer Network) risk categorizes prostate cancer based on their likelihood of disease progression, recurrence and outcomes, into low, intermediate, high and very high risk groups. It uses clinical information (i.e information available PRIOR to surgery) for this (i.e PSA, biopsy gleason score and clinical T stage)

NCCN clinical risk

Deepansh Dalela, MD

Urinary Continence Recovery

Number of Participants With Urinary Continence Recovery

Number of Participants With Peri and Postoperative Complications

Number of Participants Who Regained Potency Postoperatively (as Measured by Sexual Health Inventory for Men (SHIM) Score of 17 or Greater)

Number of Participants Who Had Biochemical Recurrence (Post-operative Prostate-Specific Antigen (PSA) Value >=0.2 ng/ml)

Post-operative Urinary Function and Urinary Function-related Quality of Life

Number of Patients Who Regained Urinary Continence Postoperatively

The numbers in this analyses are different from the primary analyses as some patients were lost to follow up (by one year)

Spots Global Cancer Trial Database for retzius sparing radical prostatectomy