Format

Send to

Choose Destination
Int Urol Nephrol. 2019 Apr 8. doi: 10.1007/s11255-019-02118-0. [Epub ahead of print]

Morphologic changes after bladder neck intussusception in laparoscopic radical prostatectomy contribute to early postoperative continence.

Yao L1,2, Chen Y1,2, Wang H3, Yu W1,2, Fan Y1,2, Yang Y1,2, Xiao Y1,2, Duan J1,2, Zhang Q1,2, He Z4,5,6, Wu S7,8,9.

Author information

1
Department of Urology, Peking University First Hospital, 8 Xishiku Street, Xicheng District, Beijing, 100034, China.
2
Institute of Urology, National Urological Cancer Center, Peking University, 8 Xishiku Street, Xicheng District, Beijing, 100034, China.
3
Department of Radiology, Peking University First Hospital, Beijing, China.
4
Department of Urology, Peking University First Hospital, 8 Xishiku Street, Xicheng District, Beijing, 100034, China. wyj7074@sohu.com.
5
Institute of Urology, National Urological Cancer Center, Peking University, 8 Xishiku Street, Xicheng District, Beijing, 100034, China. wyj7074@sohu.com.
6
Institute of Urology, National Urological Cancer Center, Peking University First Hospital, Peking University, 8 Xishiku Street, Xicheng District, Beijing, 100034, China. wyj7074@sohu.com.
7
Department of Urology, Peking University First Hospital, 8 Xishiku Street, Xicheng District, Beijing, 100034, China. wushiliangjsh@263.net.
8
Institute of Urology, National Urological Cancer Center, Peking University, 8 Xishiku Street, Xicheng District, Beijing, 100034, China. wushiliangjsh@263.net.
9
Institute of Urology, National Urological Cancer Center, Peking University First Hospital, Peking University, 8 Xishiku Street, Xicheng District, Beijing, 100034, China. wushiliangjsh@263.net.

Abstract

PURPOSE:

To explore the mechanism and efficacy of the modified bladder neck intussusception in laparoscopic radical prostatectomy (LSRP) on postoperative early continence.

METHODS:

We prospectively collected clinical information of prostate cancer patients who underwent LSRP with modified bladder neck intussusception (n = 10) and non-intussusception (n = 10). At postoperative 1 month, the prostate-specific antigen (PSA), pad test, real-time magnetic resonance imaging (rt-MRI), and flow rate were performed. At postoperative 3 months, the PSA, pad test, international prostate symptom score (IPSS), overactive bladder symptom score (OABSS), incontinence questionnaire short form (ICI-Q-SF), and quality of life (Qol) were recorded.

RESULTS:

The intussusception and non-intussusception patients had similar baseline characteristics. At postoperative 3 months, intussusception patients had lower OABSS than non-intussusception patients (P = 0.038). The non-intussusception patients suffered from more severe incontinence (P = 0.026). The continence rate of intussusception patients was significantly higher (90% vs. 20%, P = 0.005). And intussusception patients had significantly lower Qol scores (P = 0.038). According to the morphologic analysis by rt-MRI, there were 7/10 non-intussusception patients and 2/10 intussusception patients having funnel-shaped bladder necks at Valsalva movement. The intussusception patients had larger angle between anterior and posterior wall at bladder neck (P = 0.029) and longer length of functional posterior urethra (P = 0.029). During micturition, the intussusception bladder neck was found to move less dynamically on X-axis and Y-axis, but the difference did not reach significance.

CONCLUSIONS:

The modified technique of bladder neck intussusception in laparoscopic radical prostatectomy prolongs the length of functional posterior urethra and is effective to improve postoperative early continence.

KEYWORDS:

Magnetic resonance imaging; Prostate cancer; Radical prostatectomy; Urinary incontinence

PMID:
30963452
DOI:
10.1007/s11255-019-02118-0

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center