My Compass

Background: Retzius-sparing robotic-assisted radical prostatectomy (RS-RARP) has proven efficacy in earlier recovery of urinary continence.

Aim: To report the first experience with Retzius-sparing robotic-assisted radical prostatectomy in the UAE and the Arab world.

Methods: 70 patients undergoing RS-RARP at our hospital from May 2021 until May 2023. We performed a retrospective analysis of prospectively collected data. Full Continence was defined as using zero or one precautionary pad. Immediate continence was defined as continence achieved within 30 days of surgery.

Results: Median age was 60. Median BMI was 27.5, and median PSA was 7.5. Biopsy showed prostate cancer G.S 7 in most patients. All patients underwent successful surgery without conversion to open approach. None of the patient had any intra-operative complications. The median console time was 90 minutes, and the median estimated blood loss was 120 ml. Median hospital stay was one day. One patient had delayed bleeding necessitating transfusion and prolonged hospitalization. With a median follow up of 14 months, 89% of patients were immediately continent and 96% were continents at 6 months. Median time to continence was 6 days.

Conclusion: RS-RARP showed excellent early continence in the diverse population of Dubai and UAE. Findings are consistent with studies published in the USA and Europe.

Keywords: Retzius-sparing, robotic-assisted radical prostatectomy, prostate cancer, continence.

The debate surrounding the use of euthanasia and palliative care is a complex and controversial issue that raises significant questions about the nature of life and the values that shape our approach to end-of-life care. While both euthanasia and palliative care aim to alleviate the suffering of patients with terminal illnesses, they take very different approaches to achieve their objectives. The following dissertation aims to come to a conclusion on whether euthanasia should be used as an alternative to palliative care for those who are terminally ill, analysing the arguments for and arguments against euthanasia, drawing on statistics and beliefs from secondary sources such as peer-reviewed journals, websites, and books. The arguments explored include personal autonomy, the reduction of suffering, resource allocation, the sanctity of life, the slippery slope, and uncertainty in prognosis. Ultimately, this dissertation concludes that euthanasia and physician-assisted suicide should be legalised, with appropriate safeguards and regulations in place, as the benefits of such an approach outweigh the potential drawbacks, such as the slippery slope and ethical concerns in vulnerable societies.