[Effects of bladder neck preservation and reconstruction of rhabdosphincter on urinary continence recovery after laparoscopic radical prostatectomy].

OBJECTIVE

To retrospectively analyze the effects of bladder neck preservation (BNP) and reconstruction of rhabdosphincter (RS) on urinary continence recovery for patients after laparoscopic radical prostatectomy (LRP).

METHODS

Bladder neck preservation plus reconstruction of rhabdosphincter (BNP+RS) was employed in 18 prostate cancer patients after LRP from January 2011 to December 2012. Eighteen contemporary cases of routine LRP were selected for control group. The operative duration, blood loss volume, postoperative surgical margins, urine leakage and continence rate were compared between two groups.

RESULTS

LRP was successfully performed through extraperitoneal space in all 36 cases. There was no conversion into open surgery. The median operative duration, blood loss volume, positive surgical margins and urine leakage rate in BNP+RS and control groups were 164 (125-245) versus 142 (95-210) min, 195 (80-550) versus 230 (120-400) ml, 3 versus 2 cases and 0 versus 2 cases respectively. At 3, 6, 12 months, the continence rates in BNP+RS and control groups were 12 cases (66.7%) versus 5 cases (13.9%, P = 0.044) , 15 cases(83.3%) versus 11 cases (30.6%, P = 0.264) and 16 cases (88.9%) versus 13 cases (36.1%, P = 0.402) respectively. A significant higher continence rate in the first 3 months postoperatively was found in BNP+RS group than control group.

CONCLUSION

BNP plus RS reconstruction after LRP can significantly improve continence in the first 3 months after operation.