Evidence comparing urinary continence outcomes between robot-assisted radical prostatectomy (RARP) and laparoscopic radical prostatectomy (LRP) remains conflicting, largely due to heterogeneity in continence definitions and assessment methods. We compared continence recovery after RARP versus LRP using the 24-hour pad test (24 h-PT) and evaluated the impact of different continence definitions on reported outcomes. We analyzed a prospectively maintained database of consecutive patients undergoing RARP or LRP between 2008 and 2025 at a tertiary center. Urinary continence was assessed during the first postoperative year at predefined time points using pad-per-day (PPD) counts and the 24-hour pad test (24 h-PT). Continence recovery was analyzed using Kaplan–Meier methods, and adjusted hazard ratios were estimated using Cox proportional hazards models. A total of 1943 patients were included, of whom 42
Infrarenal aortic dissection is a rare condition, and the presence of a triple lumen has been described as a marker of instability and poor prognosis. We report the case of a 56-year-old woman with infrarenal dissection and triple lumen who presented with refractory abdominal pain. Owing to hostile anatomy, conventional endografts were unsuitable. An iliac branch device was used off-label as the main body, achieving complete reconstruction and preservation of bilateral iliac flow. This case expands previous off-label applications of iliac branch devices, demonstrating feasibility in infrarenal dissection beyond aneurysmal or occlusive disease.
OBJECTIVES:To evaluate the correlation between the pad-per-day (PPD) count and the 24-h pad test (24 h-PT) during the first postoperative year after radical prostatectomy (RP), and to determine the clinical utility of the PPD count for quantitative urinary incontinence (UI) assessment. PATIENTS AND METHODS:We retrospectively analysed a prospectively maintained database of 2040 men who underwent RP between 2001 and 2025 at a tertiary referral centre. A total of 8787 paired measurements of PPD count and 24 h-PT were analysed. Urinary leakage was assessed at standardised timepoints (1 week, 6 weeks, 3, 6, and 12 months) using count of PPD and nurse-supervised 24 h-PT. UI severity was classified as mild (<100 g), moderate (100-400 g), or severe (>400 g). Correlations were calculated using Spearman's ρ. RESULTS:The correlation between the PPD count and 24 h-PT was strong across all timepoints and increased over the postoperative year, from ρ = 0.77 at 1 week to 0.99 at 12 months. The overall correlation for all paired measurements was ρ = 0.94 (95% confidence interval 0.93-0.94). The median (interquartile range) 24 h-PT values rose consistently with increasing PPD count categories: from 15 (7-38) g for 1 pad/day to 781 (478-1200) g for ≥5 pads/day. At 12 months, 94% of men using one pad had urine loss <100 g, whereas 85% of those using ≥5 pads/day exceeded 400 g. Intermediate categories (2-4 pads/day) showed wide variability, limiting their discriminative value. CONCLUSIONS:The PPD count shows a strong correlation with 24 h-PT throughout the first postoperative year after RP. Use of 0-1 pad/day effectively excluded moderate-to-severe UI, whereas ≥5 pads/day reliably identified severe UI. The PPD count is a practical follow-up tool, while 24 h-PT remains necessary for patients using 2-4 pads/day.
