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Modified radical retropubic prostatectomy: Personal technical variation “tension free continuum-urethral anastomosis (T.F.C.U.A)” with optical magnification in the preservation of the bladder neck, and estimation of the urinary continence

Alberto Roggia, Emilio Pozzi, Guglielmo Mantica, Maurizio Salvadore, Dimitrios Choussos, Carmelo Di Franco, Carlo Maria Bianchi
  • Alberto Roggia
    Division of Urology - Hospital Sant’Antonio Abate - Gallarate (Va), Italy
  • Emilio Pozzi
    Division of Urology - Hospital Sant’Antonio Abate - Gallarate (Va), Italy | pozzi.emilio@libero.it
  • Guglielmo Mantica
    Division of Urology - Hospital Sant’Antonio Abate - Gallarate (Va), Italy
  • Maurizio Salvadore
    Division of Anatomopathology - Hospital Sant’Antonio Abate - Gallarate (Va), Italy
  • Dimitrios Choussos
    Graduate School of Urology - University of Pavia, Italy
  • Carmelo Di Franco
    Graduate School of Urology - University of Pavia, Italy
  • Carlo Maria Bianchi
    Graduate School of Urology - University of Pavia, Italy

Abstract

Objective: To reassess the double continence technique for open retropubic radical prostatectomy, proposed by Malizia and employed by Pagano et al., with the “tension free continuum-urethral anastomosis” (T.F.C.U.A.) personal modification and the use of image magnification optical systems and appropriate and delicate surgical tools. Materials and methods: A total of 173 radical retropubic prostatectomies, performed by the same surgeon, were evaluated in terms of early and late continence. Results: The presence of residual prostate cancer cells within the muscle layer was always excluded by the histopathological examination that also demonstrated that the muscle layer was well represented; satisfactory outcomes were obtained in terms of both early urinary continence (60%) and urinary continence at 6-12 month follow-up (92.4% for the whole series and 97.2% for the last series of patients). Conclusions: The “tension free” anastomosis obtained by the suspension of the anterior bladder wall to the the pubis along the median line allowed to achieve satisfactory outcomes in terms of urinary continence, even if these data obviously need to be confirmed by other series and comparative trials.

Keywords

Prostate cancer; Modified radical prostatectomy; Urinary continence; Double continence technique; Tension free anastomosis

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Submitted: 2014-01-02 16:01:49
Published: 2013-12-31 00:00:00
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Copyright (c) 2013 Alberto Roggia, Emilio Pozzi, Guglielmo Mantica, Maurizio Salvadore, Dimitrios Choussos, Carmelo Di Franco, Carlo Maria Bianchi

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