Bladder neck preservation during radical retropubic prostatectomy and postoperative urinary continence.
BACKGROUND
Bladder neck-sparing modification of radical retropubic prostatectomy has been reported to lower the risk of urinary incontinence after prostatectomy. We reviewed the outcomes in men with prostate cancer who had undergone prostatectomy with either bladder neck preservation or bladder neck reconstruction.


METHODS
In this retrospective study, a total of 103 patients who had undergone radical retropubic prostatectomy were assessed. The patients were divided into two groups of bladder neck preservation (51 patients) and bladder neck reconstruction (52 patients). We compared frequency of biochemical failure, bladder neck stricture, and urinary incontinence between these two groups. Biochemical failure was defined as a serum prostate-specific antigen level higher than 0.2 ng/mL and its rising trend in at least 2 postoperative subsequent measurements. Continence was defined as no need to use sanitary pads or diapers.


RESULTS
The two groups were comparable in terms of age, serum prostate-specific antigen level, Gleason score, and prostate volume. After a mean follow-up period of 32.5 months, all patients with bladder neck preservation and 46 (88.5%) with bladder neck reconstruction were continent (P = .03). There were no significant differences in the frequency of biochemical failure and bladder neck stricture that required dilation between the two groups of patients.


CONCLUSIONS
Bladder neck preservation during radical retropubic prostatectomy may improve long-term results of urinary continence and be effective in eradicating prostate cancer without increasing recurrence rate.
Razi
Ali
A
Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. reza_mehr@yahoo.com
Yahyazadeh
Seyed Reza
SR
Sedighi Gilani
Mohammad Ali
MA
Kazemeyni
Seyed Mohammad
SM
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014521:Urethra; D001748:Urinary Bladder Neck Obstruction / Q000453:epidemiology / Q000517:prevention & control; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000517:prevention & control
D017430:Prostate-Specific Antigen