Operative prostatomy: an aid to urethral anastomosis. A preliminary report.

Prostatomy is a technique that may be utilized during radical prostatectomy and bowel substitution for end stage bladder disease to preserve the urethral segment, thereby facilitating subsequent anastomosis. Although it is not applicable to all stages of prostate cancer, the technique involves a progressive longitudinal incision in the anterior prostate from the bladder neck to the proximal apex of the prostate until the divergence of the lateral lobes is visualized, thereby allowing precise identification of the entire supra-diaphragmatic urethra. This permits maximal preservation of the urethra to improve the likelihood of continence.