title: Preservation of the internal vesical sphincter and proximal urethra during retropubic radical prostatectomy may improve earlier recovery of continence in selected patients.
abstract: OBJECTIVE
  To evaluate the influence of preservation of the muscular internal sphincter and proximal urethra on continence recovery after radical prostatectomy (RP).
  
  
  METHODS
  Fifty-five consecutive patients with organ confined prostate cancer were submitted to RP with the preservation of muscular internal sphincter and the proximal urethra (group 1) and compared to 55 patients submitted to standard procedure (group 2). Continence rates were assessed using a self-administrated questionnaire at 3, 7, 30 days and 3, 12 months after removal of the catheter.
  
  
  RESULTS
  Group 1 had a faster recovery of continence than group 2 at 3 days (50.9% vs. 25.5%; P=.005), at 7 days (78.2% vs. 58.2%; P=.020), at 30 days (80.0% vs. 61.8%; P=.029) and at 3 months (81.8% vs. 61.8%; P=.017); there were no statistically difference in terms of continence at 12 months among the two groups. Multivariate logistic regression analysis of continence showed that surgical technique was significantly associated with earlier time to continence at 3 and 7 days. The two groups had no significant differences in terms of surgical margins.
  
  
  CONCLUSIONS
  Our modified technique of RP with preservation of smooth muscular internal sphincter as well as of the proximal urethra during bladder neck dissection resulted in significant increased early urinary continence at 3, 7, 30 days and 3 months after catheter removal. The technique does not increase the rate of positive margins and the duration of the procedure.
authors.affiliation: Departamento de Urología, Universidad de Bolonia, Hospital S. Orsola-Malpighi, Bolonia, Italia.
authors.forename: E
authors.initials: E
authors.lastname: Brunocilla
authors.affiliation: Departamento de Urología, Universidad de Bolonia, Hospital S. Orsola-Malpighi, Bolonia, Italia.
authors.forename: R
authors.initials: R
authors.lastname: Schiavina
authors.affiliation: Departamento de Urología, Universidad de Bolonia, Hospital S. Orsola-Malpighi, Bolonia, Italia. Electronic address: mark.borghesi@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Borghesi
authors.affiliation: Departamento de Urología, Universidad de Bolonia, Hospital S. Orsola-Malpighi, Bolonia, Italia.
authors.forename: C
authors.initials: C
authors.lastname: Pultrone
authors.affiliation: Departamento de Urología, Universidad de Bolonia, Hospital S. Orsola-Malpighi, Bolonia, Italia.
authors.forename: V
authors.initials: V
authors.lastname: Vagnoni
authors.affiliation: Departamento de Urología, Universidad de Bolonia, Hospital S. Orsola-Malpighi, Bolonia, Italia.
authors.forename: M S
authors.initials: MS
authors.lastname: Rossi
authors.affiliation: Departamento de Urología, Universidad de Bolonia, Hospital S. Orsola-Malpighi, Bolonia, Italia.
authors.forename: M
authors.initials: M
authors.lastname: Cevenini
authors.affiliation: Departamento de Urología, Universidad de Bolonia, Hospital S. Orsola-Malpighi, Bolonia, Italia.
authors.forename: L
authors.initials: L
authors.lastname: Bianchi
authors.affiliation: Departamento de Urología, Universidad de Bolonia, Hospital S. Orsola-Malpighi, Bolonia, Italia.
authors.forename: E
authors.initials: E
authors.lastname: Molinaroli
authors.affiliation: Departamento de Urología, Universidad de Bolonia, Hospital S. Orsola-Malpighi, Bolonia, Italia.
authors.forename: G
authors.initials: G
authors.lastname: Gentile
authors.affiliation: Departamento de Urología, Universidad de Bolonia, Hospital S. Orsola-Malpighi, Bolonia, Italia.
authors.forename: G
authors.initials: G
authors.lastname: Martorana
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D020127:Recovery of Function; D013997:Time Factors; D014521:Urethra; D001743:Urinary Bladder; D014554:Urination
keywords: Continencia urinaria; Cáncer de próstata; Esfínter urinario; Prostate cancer; Prostatectomía radical; Radical prostatectomy; Urethra; Uretra; Urinary continence; Urinary sphincter