Urinary continence and pathological outcome after bladder neck preservation during radical retropubic prostatectomy: A randomized prospective trial

Urinary continence and pathological outcome after bladder neck preservation during radical retropubic prostatectomy: A randomized prospective trial

Author Srougi, M. Google Scholar
Nesrallah, L. J. Google Scholar
Kauffmann, JR Google Scholar
Nesrallah, A. Google Scholar
Leite, KRM Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Purpose: Bladder neck preservation during radical prostatectomy has been advocated for improving urinary continence. We compared bladder neck preservation and resection in a randomized trial, looking at continence rates and surgical cancer control.Materials and Methods: Patients with stage T1c-T2c prostate cancer underwent radical retropubic prostatectomy with maximal preservation of the external urinary sphincter. Bladder neck preservation or resection was chosen by chance during surgery. Urinary continence (1 or no protective pad daily) was assessed by interview 2 days after catheter removal, and 2 and 6 months after surgery. the surgeon, pathologist and interviewer were the same throughout. Neither patient nor interviewer knew which procedure was done. Planned enrollment was 120.Results: Enrollment was stopped after 70 patients because surgical margins were positive only at the bladder neck in 10% of the preservation group but in none of the resection group (p = 0.08). Each group was assigned 35 patients but the bladder neck could not be preserved in 4 and 1 died, leaving 31 in the preservation group and 38 in the resection group. There were no statistically significant differences between groups in early or late urinary continence rates. Two days after catheter removal, and 2 and 6 months after surgery the respective rates were 79%, 87% and 95% with resection, and 67%, 87% and 97% with preservation.Conclusions: in our opinion bladder neck preservation during radical retropubic prostatectomy does not improve urinary continence and might compromise cancer control. the external sphincter appears more important for continence after radical prostatectomy.
Keywords prostatectomy
urinary incontinence
bladder
Language English
Date 2001-03-01
Published in Journal of Urology. Philadelphia: Lippincott Williams & Wilkins, v. 165, n. 3, p. 815-818, 2001.
ISSN 0022-5347 (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 815-818
Origin http://dx.doi.org/10.1016/S0022-5347(05)66534-2
Access rights Closed access
Type Article
Web of Science ID WOS:000166905300019
URI http://repositorio.unifesp.br/handle/11600/26501

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