학술논문

Is there any difference in urinary continence between bilateral and unilateral nerve sparing during radical prostatectomy? A systematic review and meta-analysis
Document Type
article
Source
World Journal of Surgical Oncology, Vol 22, Iss 1, Pp 1-11 (2024)
Subject
Radical prostatectomy
Urinary continence
Bilateral nerve sparing
Unilateral nerve sparing
Systematic review
Surgery
RD1-811
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
Language
English
ISSN
1477-7819
Abstract
Abstract Context In men with prostate cancer, urinary incontinence is one of the most common long-term side effects of radical prostatectomy (RP). The recovery of urinary continence in patients is positively influenced by preserving the integrity of the neurovascular bundles (NVBs). However, it is still unclear if bilateral nerve sparing (BNS) is superior to unilateral nerve sparing (UNS) in terms of post-RP urinary continence. The aim of this study is to systematically compare the differences in post-RP urinary continence outcomes between BNS and UNS. Methods The electronic databases of PubMed and Web of Science were comprehensively searched. The search period was up to May 31, 2023. English language articles comparing urinary continence outcomes of patients undergoing BNS and UNS radical prostatectomy were included. Meta-analyses were performed to calculate pooled relative risk (RR) estimates with 95% confidence intervals for urinary continence in BNS and UNS groups at selected follow-up intervals using a random-effects model. Sensitivity analyses were performed in prospective studies and robotic-assisted RP studies. Results A meta-analysis was conducted using data from 26,961 participants in fifty-seven studies. A meta-analysis demonstrated that BNS improved the urinary continence rate compared to UNS at all selected follow-up points. RRs were 1.36 (1.14–1.63; p = 0.0007) at ≤ 1.5 months (mo), 1.28 (1.08–1.51; p = 0.005) at 3–4 mo, 1.12 (1.03–1.22; p = 0.01) at 6 mo, 1.08 (1.05–1.12; p