The impact of bladder neck sparing on urinary continence during laparoscopic radical prostatectomy; Results from a high volume centre

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Ali Serdar Gozen *
Yigit Akin
Mutlu Ates
Marcel Fiedler
Jens Rassweiler
(*) Corresponding Author:
Ali Serdar Gozen | asgozen@yahoo.com

Abstract

Objective: To evaluate the effects of bladder neck reconstruction techniques on early continence after laparoscopic radical prostatectomy (LRP). Materials and methods: This non-randomized retrospective study analyzed prospectively collected data concerning LRP. In total, 3107 patients underwent LRP between March 1999 and December 2016. Exclusion criteria were preoperative urinary incontinence, previous history of external beam radiotherapy, co-morbities which may affect urinary continence such as diabetes mellitus and/or neurogenic disorders, irregular followup, and follow-up shorter than 24 months. All patients were divided into one of three groups, posterior reconstruction being performed in Group 1 (n = 112), anterior reconstruction in Group 2 (n = 762), and bladder neck sparing (BNS) in Group 3 (n = 987). Demographic and pre-, peri-, and postoperative data were collected. Multivariate analyses were performed to determine factors affecting early continence after LRP. Results: 1861 patients were enrolled in the study. The mean follow-up period was 48.12 ± 29.8 months, and subjects’ mean age was 63.6 ± 6.2 years. There was no significant difference among the groups in terms of demographic or preoperative data. Postoperative data, including oncological outcomes, were similar among the groups. The level of early continence was higher in Group 3 than in the other groups (p < 0.001). Multivariate analyses identified BNS and age as parameters significantly affecting early continence levels after LRP (p < 0.001 and p < 0.001, respectively). Bladder neck reconstruction provided less earlier continence than BNS.

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Author Biographies

Ali Serdar Gozen, Department of Urology, SLK-Klinikum Heilbronn, University of Heidelberg, Heilbronn

Department of Urology

Yigit Akin, Department of Urology, Izmir Katip Celebi University School of Medicine, Izmir

Department of Urology

Mutlu Ates, Department of Urology, Antalya Teaching and Research Hospital, Antalya

Department of Urology

Marcel Fiedler, Department of Urology, SLK-Klinikum Heilbronn, University of Heidelberg, Heilbronn

Department of Urology

Jens Rassweiler, Department of Urology, SLK-Klinikum Heilbronn, University of Heidelberg, Heilbronn

Department of Urology