{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T10:23:46Z","timestamp":1777890226862,"version":"3.51.4"},"reference-count":57,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T00:00:00Z","timestamp":1675814400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The aim of our study is to evaluate the prevalence and predictive factors of short- (30 d) and mid-term continence in a contemporary cohort of patients treated with robotic-assisted laparoscopic prostatectomy (RALP) without any posterior or anterior reconstruction at our referral academic center. Methods: Data from patients undergoing RALP between January 2017 and March 2021 were prospectively collected. RALP was performed by three highly experienced surgeons following the principles of the Montsouris technique, with a bladder-neck-sparing intent and maximal preservation of the membranous urethra (if oncologically safe) without any anterior\/posterior reconstruction. (Self-assessed urinary incontinence (UI) was defined as the need of one or more pads per die (excluding the need for a safety pad\/die. Univariable and multivariable logistic regression analysis was used to assess the independent predictors of early incontinence among routinely collected patient- and tumor-related variables). Results: A total of 925 patients were included; of these, 353 underwent RALP (38.2%) without nerve-sparing intent. The median patient age and BMI were 68 years (IQR 63\u201372) and 26 (IQR 24.0\u201328.0), respectively. Overall, 159 patients (17.2%) reported early (30 d) incontinence. In multivariable analysis adjusting for patient- and tumor-related features, a non-nerve-sparing procedure (OR: 1.57 [95% CI: 1.03\u20132.59], p = 0.035) was independently associated with the risk of urinary incontinence in the short-term period, while the absence of cardiovascular diseases before surgery (OR: 0.46 [95% CI: 0.320.67], p \u2264 0.01) was a protective factor for this outcome. At a median follow-up of 17 months (IQR 10\u201324), 94.5% of patients reported to be continent. Conclusions: In experienced hands, most patients fully recover urinary continence after RALP at mid-term follow-up. On the contrary, the proportion of patients who reported early incontinence in our series was modest but not negligible. The implementation of surgical techniques advocating anterior and\/or posterior fascial reconstruction might improve the early continence rate in candidates for RALP.<\/jats:p>","DOI":"10.3390\/jcm12041358","type":"journal-article","created":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T01:37:07Z","timestamp":1675906627000},"page":"1358","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Urinary Continence Recovery after Robotic Radical Prostatectomy without Anterior or Posterior Reconstruction: Experience from a Tertiary Referral Center"],"prefix":"10.3390","volume":"12","author":[{"given":"Francesco","family":"Sessa","sequence":"first","affiliation":[{"name":"Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, 50100 Florence, Italy"},{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50100 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6898-7698","authenticated-orcid":false,"given":"Rossella","family":"Nicoletti","sequence":"additional","affiliation":[{"name":"Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, 50100 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0667-1468","authenticated-orcid":false,"given":"Alessio","family":"Pecoraro","sequence":"additional","affiliation":[{"name":"Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, 50100 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0798-0171","authenticated-orcid":false,"given":"Paolo","family":"Polverino","sequence":"additional","affiliation":[{"name":"Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, 50100 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Rivetti","sequence":"additional","affiliation":[{"name":"Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, 50100 Florence, Italy"},{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50100 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4316-9055","authenticated-orcid":false,"given":"Francesco Lupo","family":"Conte","sequence":"additional","affiliation":[{"name":"Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, 50100 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mattia","family":"Lo Re","sequence":"additional","affiliation":[{"name":"Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, 50100 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Belmonte","sequence":"additional","affiliation":[{"name":"Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, 50100 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Alberti","sequence":"additional","affiliation":[{"name":"Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, 50100 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edoardo","family":"Dibilio","sequence":"additional","affiliation":[{"name":"Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, 50100 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Lucia","family":"Gallo","sequence":"additional","affiliation":[{"name":"Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, 50100 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alekseja","family":"Manera","sequence":"additional","affiliation":[{"name":"Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, 50100 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7877-221X","authenticated-orcid":false,"given":"Mauro","family":"Gacci","sequence":"additional","affiliation":[{"name":"Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, 50100 Florence, Italy"},{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50100 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arcangelo","family":"Sebastianelli","sequence":"additional","affiliation":[{"name":"Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, 50100 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graziano","family":"Vignolini","sequence":"additional","affiliation":[{"name":"Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, 50100 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Serni","sequence":"additional","affiliation":[{"name":"Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, 50100 Florence, Italy"},{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50100 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5237-0888","authenticated-orcid":false,"given":"Riccardo","family":"Campi","sequence":"additional","affiliation":[{"name":"Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, 50100 Florence, Italy"},{"name":"Department of Experimental and Clinical Medicine, University of Florence, 50100 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6328-7980","authenticated-orcid":false,"given":"Vincenzo","family":"Li Marzi","sequence":"additional","affiliation":[{"name":"Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, 50100 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1977","DOI":"10.1056\/NEJMoa043739","article-title":"Radical Prostatectomy versus Watchful Waiting in Early Prostate Cancer","volume":"352","author":"Holmberg","year":"2005","journal-title":"N. 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