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23/05/2024

For the second year in a row, a research study from the Vall d'Hebron Urology Service has been recognised by the UB-HUB Chair of Robotic Surgery ABEX

Lucas Regis guanyador catedra UB-HUB de Cirurgia Robòtica ABEX

23/05/2024

The work led by Dr. Regis demonstrates that performing robotic reconstruction after radical prostatectomy is associated with better urinary control.

A study from the Urology Service of the Vall d’Hebron University Hospital has won the award granted by the UB-HUB Chair of Robotic Surgery ABEX for the best research on robotic surgery in the field of urology. This is the second consecutive year that a study from the Vall d'Hebron Institute of Research (VHIR) has received the award in this category. The study led by Dr. Lucas Regis, an attending physician in the Urology Service dedicated to Prostate Cancer and Renal Transplantation and a researcher in the Biomedical Research in Urologia group, has investigated how to improve urinary continence recovery after total prostatectomy. The information from the article published in the European Journal of Radiology will guide subsequent interventions to improve the quality of life of patients.

Urinary incontinence is one of the complications that most affects the quality of life of patients after total prostatectomy and is also one of the most common. Studies show that only 10% of robotic surgery patients still experience incontinence one year after surgery. However, early recovery is the major challenge of this procedure. Technical variations aim to reduce the time to urine control, allowing patients to resume their normal activities sooner after cancer treatment.

Several pre-existing factors before the intervention affect recovery: age, prostate size, and pre-existing urinary problems, among others... However, more importance lies in the anatomical changes associated with the intervention, such as pelvic musculature modification and physical alterations in the urinary sphincter system. Currently, there are several reconstruction procedures after surgery to try to regain or at least improve continence, but data were lacking to determine which one was most suitable for each patient's condition. For the first time, a study has shown that robotic reconstruction after radical prostatectomy repositions the urethrovesical anastomosis, which is associated with earlier recovery of urinary control.

Using imaging diagnostic techniques such as magnetic resonance, they discovered that a key predictive factor is the height at which the urethrovesical anastomosis is reformed, or the junction between the urethra and the urinary bladder. Therefore, reconstruction techniques should focus on placing this junction in the ideal position to improve continence. Having accurate images of the changes the patient has undergone after surgery and a clear indication of which position will give better results will help the team decide which procedure is most suitable in each case. The aim is to improve the patient's quality of life by eliminating one of the most troublesome complications for them. The study data reinforce the benefits of postoperative reconstruction, evidence anatomical bases related to early recovery of urinary control, and confirm the path towards a standardized technique.

Dr. Regis explains that "this study opens the door to better patient recovery after surgery, although it should be repeated with a larger sample to finalize some of the conclusions". The doctor would also wants to thank the HUB Chair of Robotic Surgery ABEX for their recognition.

Awards from the UB-HUB Chair of Robotic Surgery ABEX

The UB-HUB Chair of Robotic Surgery ABEX, affiliated with the Bellvitge Campus of the Faculty of Medicine and Health Sciences of the University of Barcelona, has been awarding 5 prizes for research in robotic surgery for a year. The awards have been given to papers published during the years 2021 and 2022 in national and international journals in the fields of urology, general and digestive surgery, thoracic surgery, gynaecology and obstetrics, and otorhinolaryngology. The aim was to recognise the efforts of the surgical teams in learning and research in this field, as well as to establish and consolidate links with other hospital centres.
 

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