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Eur Urol. 2007 Apr;51(4):996-1003. Epub 2006 Oct 23.

Posterior reconstruction of the rhabdosphincter allows a rapid recovery of continence after transperitoneal videolaparoscopic radical prostatectomy.

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  • 1Division of Urology, European Institute of Oncology, Milan, Italy.

Abstract

OBJECTIVES:

Urinary incontinence is one of the major drawbacks of radical retropubic prostatectomy (RRP). One of the possible reasons for this urinary incontinence is a postoperative deficiency of the rhabdosphincter (RS). It has been recently demonstrated that reconstruction of the posterior aspects of the RS allows a rapid recovery of continence after RRP. This study evaluated the application of this technique in videolaparoscopic radical prostatectomy (VLRP), assessing the percentage of continent patients at 3, 30, and 90 d after catheter removal.

METHODS:

A two-arm prospective comparative trial was carried out with 31 patients recruited for each arm. Group A underwent standard VLRP and group B underwent VLRP with RS reconstruction (VLRP-R). Continence was defined as no pads or one diaper/24h and was assessed 3, 30, and 90 d after the procedure.

RESULTS:

At catheter removal, 74.2% versus 25% (p=0.0004) of patients were continent with the VLRP-R technique versus VLRP, respectively. A statistically significant difference was present at 30 d (83.8% vs. 32.3%; p=0.0001) At 90 d the difference, although still present, was not statistically significant (92.3% vs. 76.9%; p=0.25).

CONCLUSIONS:

In this preliminary report, the posterior reconstruction of the RS appears to be an easy and feasible technique even in a laparoscopic setting. Time to continence recovery was significantly shortened.

PMID:
17079070
[PubMed - indexed for MEDLINE]
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