Creation of a tubularized neourethra following radical retropubic prostatectomy.

Creation of a neourethra by tubularization of the anterior bladder wall during bladder reconstruction at radical retropubic prostatectomy resulted in earlier return of urinary control. The tubularized neourethra appeared to affect postoperative urinary continence by increasing both functional urethral length and bladder leak point pressure. The surgical technique has been modified by tubularizing the anterior bladder around a larger catheter (22 French) and by ensuring a mucosal to mucosal posterior edge of the neourethra. These changes have reduced the rate of postoperative bladder and urethral stricture occurrence to that observed for standard bladder neck reconstruction after radical retropubic prostatectomy.