Urodynamic evaluation of a suspension technique for rapid recovery of continence after radical retropubic prostatectomy.
BACKGROUND
We investigated urodynamic findings involved in the rapid recovery of urinary continence after radical retropubic prostatectomy with a suspension technique.


METHODS
A total of 45 consecutive patients (mean age 67.6 years) who had undergone radical retropubic prostatectomy for localized prostate cancer were evaluated with multichannel urodynamics including the maximal urethral pressure (MUP), functional urethral length (FUL), maximal cystometric capacity (MCC) and abdominal leak point pressure (ALPP) at base line, 1 week, 1 month, and 3 months postoperatively. The suspension of vesicourethral anastomosis preserving anterior attachments of puboprostatic ligaments to pubic bone was performed in 33 patients. Twelve patients did not undergo the suspension technique.


RESULTS
The continence rates at 1 week, 1 month, and 3 months after radical prostatectomy in the suspension group were significantly higher than those in the non-suspension group: 67% versus 0% at 1 week (P < 0.001), 82% versus 25% at 1 month (P < 0.001), and 91% versus 50% at 3 months (P < 0.01), respectively. Postoperative ALPP at all points of measurement was significantly higher in the suspension group than in the non-suspension group (P < 0.0002). There was no difference in MUP, FUL or MCC at each point following radical prostatectomy between the two groups.


CONCLUSIONS
These observations suggest that preserving anterior attachments of puboprostatic ligaments to pubic bone and fixation of urethral hyper-mobility by the suspension of vesicourethral anastomosis promotes rapid recovery of urinary continence after radical retropubic prostatectomy.
Noguchi
Masanori
M
Department of Urology, Kurume University School of Medicine, Kurume, Japan. noguchi@med.kurume-u.ac.jp
Shimada
Akihiko
A
Nakashima
Osamu
O
Kojiro
Masamichi
M
Matsuoka
Kei
K
D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D014563:Urodynamics / Q000502:physiology*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*