Improved early and late continence following robot‐assisted radical prostatectomy with concurrent bladder neck fascial sling (RoboSling)

Objective To describe a novel RoboSling technique performed at the time of robot-assisted radical prostatectomy (RARP) and its utility for enhancing urinary function recovery postoperatively. Materials Methods The surgical involves harvesting vascularised, fascial flap from peritoneum on posterior aspect bladder. Following completion prostatectomy, autologous is tunnelled underneath bladder incorporated into rectourethralis vertical longitudinal detrusor fibres neck with modified Rocco suture. After urethra-vesical anastomosis completed, corners are hitched up to Cooper's ligament bilaterally V-Loc sutures, tensioned secured creating sling. A prospective, cohort study was 193 consecutive patients undergoing RARP between December 2016 September 2019. first 163 underwent standard RARP, last 30 had concurrently. Continence outcomes were primary assessed using pad number Expanded Prostate Cancer Composite (EPIC)-urinary domain questionnaire. Operative (OT), estimated blood loss (EBL), complications oncological secondary outcomes. Results two groups comparable demographics clinicopathological variables. At 3 months, zero usage (p = 0.005) continence rates, defined as EPIC score ≥ 85 0.007), both higher in group. EBL, complication rate positive margin did not differ groups. Superior observed 1 year group 0.029). added average 16 min OT. Conclusions procedure associated earlier return without negatively impacting other postoperative This improvement maintained long term.