Urology

App-based modular PFMT sharply improves early continence after radical prostatectomy

In this multicenter RCT of 62 men undergoing radical prostatectomy, a modular app-based PFMT program produced 74.2% continence at 90 days versus 21.4% with standard physiotherapist-guided PFMT. The absolute risk reduction was 52.8% with a number needed to treat of 2 for continence at 90 days. The app also increased adherence and continence-related quality of life without affecting erectile function. Limitations include short follow-up; results require confirmation for longer-term continence outcomes. 1

Hugo™ RAS shows high surgical success and low conversion in US prospective trial

In this prospective multicenter study of 144 enrolled patients (137 treated), the Hugo system achieved 98.5% surgical success with a 1.5% conversion rate. Thirty-day major complication rates differed by procedure: RP 3.7%, RC 17.9%, and nephrectomy 1.9%. Positive surgical margin rates varied by operation and were reported (RP 21.8%, RC 7.1%, nephrectomy 2.4%). Authors conclude operative characteristics and short-term outcomes are consistent with existing literature. 2

Age and prostate weight predict 12-month continence and erectile outcomes after RARP

In 862 consecutive RARP patients, 50.0% were pad-free and 85.6% achieved social continence at 12 months; 71.5% had chart-documented erectile dysfunction. Multivariable analysis identified age and prostate weight as independent predictors of stress urinary incontinence, and age as the only independent predictor of erectile dysfunction. A simple composite risk score correlated with SUI in a dose-response fashion but had modest discrimination (AUC 0.597). Interpretation is limited by non-validated outcome measures and missing confounders, including nerve-sparing status. 3