Autologous Urethral Sling Does Not Improve Continence After Prostatectomy
No benefit of autologous urethral sling placement at robotic assisted radical prostatectomy on early return of continence at 6 months.
(HealthDay News) — Placement of a retropubic urethral sling fashioned from autologous vas deferens during robotic assisted radical prostatectomy does not improve recovery of continence, according to a study published in The Journal of Urology.
Hao G Nguyen, MD, PhD, from the University of California-San Francisco, and colleagues conducted a phase 2 trial in which age-stratified patients were randomized to undergo robotic assisted radical prostatectomy by multiple surgeons with or without sling placement (95 and 100 patients, respectively). The outcomes were complete and near continence at 6 months.
The researchers found that the proportions reporting complete continence were 66% and 65% for those without and with a sling, respectively, while 86% and 88%, respectively, reported near continence at 6 months after surgery; times to complete and near continence were similar between the groups. There was a correlation for younger age with higher likelihood of complete and near continence (odds ratios, 1.74 and 2.18 per decreasing 5-year interval) after adjustment for clinical, urinary, and surgical factors.
"This trial failed to demonstrate a benefit of autologous urethral sling placement at robotic assisted radical prostatectomy on early return of continence at 6 months," the authors write. "Continence was related to patient age in adjusted models."
- Nguyen HG, Punnen S, Cowan JE, et al. A Randomized Study of Intraoperative Autologous Retropubic Urethral Sling on Urinary Control after Robotic Assisted Radical Prostatectomy. J Urol. February 2017. doi: 10.1016/j.juro.2016.08.122.