A randomized clinical trial of suspension technique for improving early recovery of urinary continence after radical retropubic prostatectomy.

OBJECTIVE

To evaluate, in a prospective, single-blind, randomized trial, the safety and efficacy of a suspension technique for improving early recovery of continence after radical retropubic prostatectomy (RRP).

PATIENTS AND

METHODS

We randomly assigned 60 men with clinically localized prostate cancer to RRP; 30 were treated with the suspension technique and the remaining 30 were not. All patients had RRP by the same surgeon followed by early catheter removal on the third day after RRP. The primary outcome measures were the interval to recovery of continence, and the positive margin rates. The continence status was evaluated by a third party using validated questionnaires at baseline before RRP and at 4 and 7 days, and 2 weeks, 1, 3, 6 and 12 months after RRP.

RESULTS

The suspension technique resulted in significantly greater continence rates at 1, 3 and 6 months after RRP of 53% vs 20%, 73% vs 47% and 100% vs 83%. Kaplan-Meier curves also showed that patients in the suspension group had a significantly earlier recovery of continence than in the no-suspension group; the median (95% confidence interval) interval for recovery was 31 (12-74) days in the suspension group and 90 (65-150) days in the no-suspension group (log rank test, P = 0.002). The groups had no significant differences in their histological status.

CONCLUSIONS

The suspension technique had a significant effect on the earlier recovery of urinary continence within 6 months after RRP, without compromising the oncological outcome of RRP.