title: Veil nerve-sparing technique and postoperative urinary continence in open antegrade radical prostatectomy.
abstract: OBJECTIVE
  To introduce and evaluate our open antegrade radical prostatectomy (ARP) technique, a nerve-sparing technique which offers patients better postsurgical urinary continence by our technique of 'Veil of Aphrodite'.
  
  
  METHODS
  Ninety consecutive bilateral nerve-sparing ARPs performed using the Veil technique (intrafascial dissection) were compared to control ARP cases using non- or unilateral nerve sparing. Correlation of urinary continence with immunohistochemical (IHC) stains of nerves (S-100) around the prostate capsule was investigated in 20 consecutive patients whose ARPs were performed by a single surgeon.
  
  
  RESULTS
  Fifty-one cases (56.7%) had no urinary incontinence and 72 cases (80.0%) had no or only minor urinary leakage (less than 5% in total a day), and these were significantly higher than in the control group (p = 0.000 and 0.003, respectively) without compromising the surgical margins. S-100 IHC stains significantly correlated nerve sparing (bilateral sparing vs. non-sparing, p = 0.0398), urinary continence (no urinary continence vs. more than 5% in total urine volume a day, p = 0.0489), and early removal of catheter (within a week vs. over a week, p = 0.0041).
  
  
  CONCLUSIONS
  Open nerve-sparing ARP using the Veil technique may offer better urinary continence postoperatively and this may be supported by S-100 IHC results. This method may be adaptable in any surgical institution.
authors.affiliation: Department of Urology, Shinko Hospital, Kobe, Japan. yutoshunta@hotmail.co.jp
authors.forename: Katsumi
authors.initials: K
authors.lastname: Shigemura
authors.forename: Nozomu
authors.initials: N
authors.lastname: Yamanaka
authors.forename: Masuo
authors.initials: M
authors.lastname: Yamashita
mesh_terms: D000368:Aged; D001706:Biopsy / Q000379:methods; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008297:Male; D008875:Middle Aged; D009474:Neurons / Q000473:pathology; D011184:Postoperative Period; D011467:Prostate; D017430:Prostate-Specific Antigen / Q000096:biosynthesis; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D011788:Quality of Life; D014549:Urinary Incontinence / Q000517:prevention & control*; D014572:Urology / Q000379:methods
chemical_list: D017430:Prostate-Specific Antigen