Influence of nerve-sparing procedure on early recovery of urinary continence after laparoscopic radical prostatectomy.
OBJECTIVE
This study considered the influence of the nerve-sparing procedure on early recovery of urinary continence after laparoscopic radical prostatectomy according to preoperative erectile function.


METHODS
There were 135 patients eligible for assessment of the status of urinary continence after surgery. The patients were divided into two groups according to the International Index of Erectile Function (IIEF)-5 score: Group 1, >or=14 (56 patients); group 2, <14 (79 patients). The correlation between urinary continence and patient age at surgery, body mass index, preoperative prostate-specific antigen level, preoperative IIEF-5 score, and an attempted nerve-sparing procedure was investigated.


RESULTS
Overall continence rates were 13%, 41%, 63%, and 79% at 1, 3, 6, and 12 months, respectively. The rate in group 2 was significantly lower than that in group 1 6 months after surgery (P = 0.0286), and the rate in patients without attempted nerve sparing was significantly lower than that in those with an attempted nerve-sparing procedure at 3 months (P = 0.0084). The rate in group 2 of patients without attempted nerve sparing was significantly lower than that in those with an attempted nerve-sparing procedure at both 3 months (P = 0.0046) and 6 months postoperatively (P = 0.0356).


CONCLUSIONS
Preoperative erectile function and the nerve-sparing procedure were predictors of early recovery of urinary continence after laparoscopic radical prostatectomy. If each case fulfills the oncologic criteria for nerve sparing, we should attempt nerve sparing to facilitate the early recovery of urinary continence despite the degree of preoperative erectile function.
Takenaka
Atsushi
A
Division of Urology, Department of Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan. atake@med.kobe-u.ac.jp
Soga
Hideo
H
Sakai
Iori
I
Nakano
Yuzo
Y
Miyake
Hideaki
H
Tanaka
Kazushi
K
Fujisawa
Masato
M
D000368:Aged; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010410:Penile Erection / Q000502:physiology; D011467:Prostate / Q000294:innervation* / Q000503:physiopathology / Q000601:surgery*; D011468:Prostatectomy / Q000379:methods*; D020127:Recovery of Function / Q000502:physiology*; D014554:Urination / Q000502:physiology*