281 Identifying the relationship between postoperative urinary continence and residual urethra stump measurements in robot assisted radical prostatectomy patients Introduction Urinary incontinence after a robot assisted radical prostatectomy (RARP) appears to have a multifactorial origin1–5 Several studies have identified factors that contribute to early urinary continence in patients that underwent RARP.1,2,6–10 One of these factors is the length of the membranous urethra (MUL).4,11,12 There appears to be a correlation between the length of the MUL in pre and post-operative magnetic resonance imaging (MRI) and urinary continence.4,12 The group of Song showed that a preoperative MU ≤13.5 mm and postoperative MU ≤13 mm had a negative impact on urinary continence 12 months after the surgery. The group of Kohjimoto retrospectively investigated the relation between urinary continence and the length of the resected MU evaluating the amount of rhabdomyo sphincter on the hematoxylin and eosin sections of the apical margin of prostate specimens.11 This study showed the length of resected MUL specimen was an independent predictor of urinary incontinence. This raises the question whether assessment of the urethral length could be objectified intraoperatively by the surgeon to optimize the length of the urethra in order to reduce the risk of postoperative incontinence after RARP. In another study by the group of Ganni, Kinovea software was used to provide an objective assessment of surgical skills during laparoscopic cholecystectomy.13 Kinovea is a software-based video analysis system used in sports to track trajectories and speeds of moving items,. The authors showed that the system can be used for tracking analysis of pre-recorded surgical videos and is viable method for the objective assessment of surgical performance.13 Since Kinovea uses a reference line to measure the distance, we hypothesized it could be used to measure the size of an item from a video frame, relating the measurements to the reference line. More specifically, we hypothesize Kinovea can use the diameter of the trans-urethral catheter during dissection of the apex of the prostate in RARP as a reference line in order to be able to measure the dimensions of the urethral stump. The research questions are: (1) Is it possible to accurately assess the length and width of the urethral stump in the surgical videos of robot assisted radical prostatectomy patients using the Kinovea software? (2) Can urethral stump measurements be used to predict postoperative continence in patients after robot assisted radical prostatectomy? These questions will be answered using Kinovea, a software-based system to measure the urethral stump in surgical videos of patients who underwent RARP.
RkJQdWJsaXNoZXIy MTk4NDMw