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Early continence after radical prostatectomy: A systematic review. / Variaciones de la prostatectomía radical para una recuperación de la continencia urinaria precoz: una revisión sistemática.
Salazar, A; Regis, L; Planas, J; Celma, A; Díaz, F; Gallardo, I; Trilla, E; Morote, J.
Afiliación
  • Salazar A; Servicio de Urología, Hospital Universitari Vall d'Hebron; Universistat Autònoma de Barcelona, Barcelona, España. Electronic address: aina.salazar@gmail.com.
  • Regis L; Servicio de Urología, Hospital Universitari Vall d'Hebron; Universistat Autònoma de Barcelona, Barcelona, España.
  • Planas J; Servicio de Urología, Hospital Universitari Vall d'Hebron; Universistat Autònoma de Barcelona, Barcelona, España.
  • Celma A; Servicio de Urología, Hospital Universitari Vall d'Hebron; Universistat Autònoma de Barcelona, Barcelona, España.
  • Díaz F; Servicio de Urología, Hospital Universitari Vall d'Hebron; Universistat Autònoma de Barcelona, Barcelona, España.
  • Gallardo I; Servicio de Urología, Hospital Universitari Vall d'Hebron; Universistat Autònoma de Barcelona, Barcelona, España.
  • Trilla E; Servicio de Urología, Hospital Universitari Vall d'Hebron; Universistat Autònoma de Barcelona, Barcelona, España.
  • Morote J; Servicio de Urología, Hospital Universitari Vall d'Hebron; Universistat Autònoma de Barcelona, Barcelona, España.
Actas Urol Esp (Engl Ed) ; 43(10): 526-535, 2019 Dec.
Article en En, Es | MEDLINE | ID: mdl-31606163
ABSTRACT
BACKGROUND AND

OBJECTIVE:

Urinary incontinence is the adverse effect with more impact on patients' quality of life after undergoing radical prostatectomy. The objective of this study is to review the present evidence that describes the variations on surgical techniques which aim to preserve urinary continence after radical prostatectomy. EVIDENCE ACQUISITION We searched the literature on PubMed, Cochrane, and ScienceDirect according to the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) statement, using the PICO review protocol. The search terms were urinary continence, urinary incontinence, urinary leakage, radical prostatectomy, open radical prostatectomy, laparoscopic prostatectomy, robot-assisted laparoscopic prostatectomy, robotic prostatectomy. We identified 1,603 registers, and 27 articles were reviewed for meeting the inclusion criteria. Six of them are randomized clinical trials and 4 of them, meta-analysis. EVIDENCE

SYNTHESIS:

The surgical techniques more frequently used to achieve early urinary continence are bladder neck and neurovascular bundles preservation, as well as the reconstruction of the rhabdosphincter. The latter has been presented in three randomized clinical trials. Even though some approaches have obtained improved functional outcomes, the lack of consensus on the definition of urinary incontinence and its measurement methods have not advocated for the creation of technical recommendations based on scientific evidence.

CONCLUSIONS:

The reconstruction of the rhabdosphincter is the only technique that has shown improved functional results through randomized trials. The current evidence is limited and heterogenous, and more studies with consistent criteria are needed in order to establish a standard surgical technique.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Prostatectomía / Incontinencia Urinaria / Tratamientos Conservadores del Órgano Tipo de estudio: Clinical_trials / Etiology_studies / Guideline / Prognostic_studies / Systematic_reviews Aspecto: Patient_preference Límite: Humans / Male Idioma: En / Es Revista: Actas Urol Esp (Engl Ed) Año: 2019 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Prostatectomía / Incontinencia Urinaria / Tratamientos Conservadores del Órgano Tipo de estudio: Clinical_trials / Etiology_studies / Guideline / Prognostic_studies / Systematic_reviews Aspecto: Patient_preference Límite: Humans / Male Idioma: En / Es Revista: Actas Urol Esp (Engl Ed) Año: 2019 Tipo del documento: Article