Posterior Rhabdosphincter Reconstruction During Robot-assisted Radical Prostatectomy: Critical Analysis of Techniques and Outcomes

Many centers have recently implemented posterior rhabdosphincter reconstruction (PRR) into robot-assisted radical prostatectomy (RARP) with the objective of earlier continence recovery. We comprehensively review the anatomic and functional changes occurring post prostatectomy along with the reconstructive techniques and published outcomes of PRR. Several case control studies show a better continence rate within the first 3 months, whereas the only randomized control trial presents a conflicting conclusion. Unfortunately, all reported studies lack uniform surgical technique, continence definition, and measures, making comparison difficult. Although initial results appear favorable, the true continence benefit of PRR remains debatable and requires further research. UROLOGY 76: 734-742, 2010. (C) 2010 Published by Elsevier Inc.