Transrectal ultrasound navigation during minilaparotomy retropubic radical prostatectomy: impact on positive margin rates and prediction of earlier return to urinary continence.
OBJECTIVE
To assess the impact of transrectal ultrasound (TRUS) navigation on positive margin rates and membranous urethral length (MUL) after minilaparotomy radical retropubic prostatectomy (MRP).


METHODS
Rates of positive distal margins prior to and after the application for TRUS navigation during MRP were assessed. Of the 189 men undergoing MRP at our institution, 70 were evaluated for the clinical usefulness of preoperative and postoperative MUL. Patients filled out self-administrated questionnaires concerning continence status at 1, 3, 6, 9, and 12 months after the MRP. Surgery-related factors including MUL were analyzed for the prediction of urinary continence after MRP.


RESULTS
With the application of TRUS, the rate of positive distal margins decreased by 14%. Postoperative MUL was an independent variable predictive of urinary continence 1 month after surgery. Patients with a MUL longer than 12 mm showed a significantly more favorable recovery from urinary incontinence after surgery.


CONCLUSIONS
Application of TRUS results in a lower rate of positive margins, and a longer postoperative MUL is associated with an earlier return to urinary continence after MRP.
Okihara
Koji
K
Department of Urology, Kyoto Prefectural University of Medicine, Kamigyo-Ku, Kyoto, Japan. okihara@koto.kpu-m.ac.jp
Kamoi
Kazumi
K
Kanazawa
Motohiro
M
Yamada
Takeshi
T
Ukimura
Osamu
O
Kawauchi
Akihiro
A
Miki
Tsuneharu
T
D000368:Aged; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D020127:Recovery of Function; D012007:Rectum; D014463:Ultrasonography / Q000379:methods; D014521:Urethra / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D014554:Urination