Douglas L Gaker1, Barbara L Steel. 1. Department of Urology and Pathology, Middletown Regional Hospital, Middletown, Ohio, USA.
Abstract
PURPOSE: A continence sparing radical retropubic prostatectomy is described and evaluated. Results are compared with those of patients who underwent a standard anatomical radical retropubic prostatectomy previously by the same surgeon. MATERIALS AND METHODS: A total of 275 consecutive patients underwent a continence sparing radical prostatectomy by a single surgeon (DLG) between 1996 and 2003. The technique is described in detail. RESULTS: Total continence (no pad or device) was found immediately upon catheter removal in 36% of patients, within 14 days in 69% and within 7 weeks in 78%, compared to 1%, 6% and 41% of 80 patients who underwent the standard operation. Median time to total continence was 1 day for the new group versus 63 days for the standard surgery group. Positive margins were found in 6.9% of the new group versus 11% of the first 80 patients. Of the former patients 80% have a prostate specific antigen of less than 0.2 ng/ml at an average followup of 12.5 years. With the new procedure 90% of patients have a prostate specific antigen of less than 0.2 ng/ml with an average followup of 5.2 years. There was no operative mortality or unusual complication. The typical patient was discharged home 1 to 3 days postoperatively. CONCLUSIONS: Preservation of the continence mechanism at the level of the bladder neck and proximal prostatic urethra results in earlier return of continence without adversely affecting cancer control. It is a relatively simple way to improve surgical results.
PURPOSE: A continence sparing radical retropubic prostatectomy is described and evaluated. Results are compared with those of patients who underwent a standard anatomical radical retropubic prostatectomy previously by the same surgeon. MATERIALS AND METHODS: A total of 275 consecutive patients underwent a continence sparing radical prostatectomy by a single surgeon (DLG) between 1996 and 2003. The technique is described in detail. RESULTS: Total continence (no pad or device) was found immediately upon catheter removal in 36% of patients, within 14 days in 69% and within 7 weeks in 78%, compared to 1%, 6% and 41% of 80 patients who underwent the standard operation. Median time to total continence was 1 day for the new group versus 63 days for the standard surgery group. Positive margins were found in 6.9% of the new group versus 11% of the first 80 patients. Of the former patients 80% have a prostate specific antigen of less than 0.2 ng/ml at an average followup of 12.5 years. With the new procedure 90% of patients have a prostate specific antigen of less than 0.2 ng/ml with an average followup of 5.2 years. There was no operative mortality or unusual complication. The typical patient was discharged home 1 to 3 days postoperatively. CONCLUSIONS: Preservation of the continence mechanism at the level of the bladder neck and proximal prostatic urethra results in earlier return of continence without adversely affecting cancer control. It is a relatively simple way to improve surgical results.
Authors: K Beattie; J Symons; S Chopra; C Yuen; R Savdie; R Thanigasalam; A M Haynes; J Matthews; P C Brenner; K Rasiah; R L Sutherland; P D Stricker Journal: J Robot Surg Date: 2012-07-26
Authors: Linda M Huynh; Douglas Skarecky; James Porter; Christian Wagner; Jorn Witt; Timothy Wilson; Clayton Lau; Thomas E Ahlering Journal: Sci Rep Date: 2018-11-05 Impact factor: 4.379