title: Posterior reconstruction of the rhabdosphincter allows a rapid recovery of continence after transperitoneal videolaparoscopic radical prostatectomy.
abstract: OBJECTIVE
  Urinary incontinence is one of the major drawbacks of radical retropubic prostatectomy (RRP). One of the possible reasons for this urinary incontinence is a postoperative deficiency of the rhabdosphincter (RS). It has been recently demonstrated that reconstruction of the posterior aspects of the RS allows a rapid recovery of continence after RRP. This study evaluated the application of this technique in videolaparoscopic radical prostatectomy (VLRP), assessing the percentage of continent patients at 3, 30, and 90 d after catheter removal.
  
  
  METHODS
  A two-arm prospective comparative trial was carried out with 31 patients recruited for each arm. Group A underwent standard VLRP and group B underwent VLRP with RS reconstruction (VLRP-R). Continence was defined as no pads or one diaper/24h and was assessed 3, 30, and 90 d after the procedure.
  
  
  RESULTS
  At catheter removal, 74.2% versus 25% (p=0.0004) of patients were continent with the VLRP-R technique versus VLRP, respectively. A statistically significant difference was present at 30 d (83.8% vs. 32.3%; p=0.0001) At 90 d the difference, although still present, was not statistically significant (92.3% vs. 76.9%; p=0.25).
  
  
  CONCLUSIONS
  In this preliminary report, the posterior reconstruction of the RS appears to be an easy and feasible technique even in a laparoscopic setting. Time to continence recovery was significantly shortened.
authors.affiliation: Division of Urology, European Institute of Oncology, Milan, Italy.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Rocco
authors.forename: Andrea
authors.initials: A
authors.lastname: Gregori
authors.forename: Silvio
authors.initials: S
authors.lastname: Stener
authors.forename: Luigi
authors.initials: L
authors.lastname: Santoro
authors.forename: Andrea
authors.initials: A
authors.lastname: Bozzola
authors.forename: Stefano
authors.initials: S
authors.lastname: Galli
authors.forename: Roberto
authors.initials: R
authors.lastname: Knez
authors.forename: Francesco
authors.initials: F
authors.lastname: Scieri
authors.forename: Alessandra
authors.initials: A
authors.lastname: Scaburri
authors.forename: Franco
authors.initials: F
authors.lastname: Gaboardi
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010537:Peritoneum; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D020127:Recovery of Function; D013997:Time Factors; D014521:Urethra / Q000601:surgery*; D014549:Urinary Incontinence / Q000209:etiology / Q000517:prevention & control; D020535:Video-Assisted Surgery