Urology
Volume 69, Issue 4 , Pages 726-731 , April 2007

Anatomic Restoration Technique of Continence Mechanism and Preservation of Puboprostatic Collar: A Novel Modification to Achieve Early Urinary Continence in Men Undergoing Robotic Prostatectomy

Received 3 May 2006 ,Accepted 14 December 2006.

References 

  1. Bates TS, Wright MP, Gillat DA. Prevalence and impact of incontinence and impotence following total prostatectomy assessed anonymously by the ICS-male questionnaire. Eur Urol. 1998;33:165–169
  2. Stanford JL, Feng Z, Hamilton AS, et al. Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: the Prostate Cancer Outcomes Study. JAMA. 2000;283:354–360
  3. Fowler FJ, Barry MJ, Lu-Yao G, et al. Patient-reported complications and follow-up treatment after radical prostatectomy—the national Medicare experience: 1988–1990 (updated June 1993). Urology. 1993;42:622–629
  4. Fergus V, Coakly SE, Kattan MW, et al. Urinary continence after radical retropubic prostatectomy: relationship with membranous urethral length on preoperative endorectal magnetic resonance imaging. J Urol. 2002;168:1032–1035
  5. Deliveliotis C, Protogerous V, Alaergof E, et al. Radical prostatectomy: bladder neck preservation and puboprostatic ligament sparing—effects on continence and positive margins. Urology. 2002;60:855–858
  6. Poore RE, McCullough DL, Jarow JP. Puboprostatic ligament sparing improves urinary continence after radical retropubic prostatectomy. Urology. 1998;51:67–72
  7. Jarow JP. Puboprostatic ligament sparing radical retropubic prostatectomy. Semin Urol Oncol. 2000;18:28–32
  8. John H, Hauri D. Seminal vesicle-sparing radical prostatectomy: a novel concept to restore early urinary continence. Urology. 2000;55:820–824
  9. Hollabaugh RS, Dmochowski RR, Kneib TG, et al. Preservation of putative continence nerves during radical retropubic prostatectomy leads to more rapid return of urinary continence. Urology. 1998;51:960–967
  10. Walsh PC, Marschke PL. Intussusception of the reconstructed bladder neck leads to earlier continence after radical prostatectomy. Urology. 2002;59:934–938
  11. Campenni MA, Harmon JD, Ginsberg PC, et al. Improved continence after radical retropubic prostatectomy using two pubo-urethral suspension stitches. Urol Int. 2002;68:109–112
  12. Nougchi M, Noda S, Nakashima O, et al. Suspension technique improves rapid recovery of urinary continence following radical retropubic prostatectomy. Kurume Med J. 2004;51:245–251
  13. Jones JS, Vasavada SP, Abdelmalak JB, et al. Sling may hasten return of continence after radical prostatectomy. Urology. 2005;65:1163–1167
  14. Myers RP. Detrusor apron, associated vascular plexus, and avascular plane: relevance to radical retropubic prostatectomy—anatomic and surgical commentary. Urology. 2002;59:472–479
  15. Myers RP, Cahill DR, Kay PA, et al. Puboperineales: muscular boundaries of the male urogenital hiatus in 3D from magnetic resonance imaging. J Urol. 2000;164:1412–1415
  16. Tewari A, and Rao SR: Anatomical foundations and surgical maneuver for precise identification of prostatovesical junction during robotic radical prostatectomy. BJU Int (in press).
  17. Takenaka A, Leung RA, Tewari A. Anatomy of autonomic nerve component in the male pelvis—the new concept from a perspective for robotic nerve sparing radical prostatectomy. World J Urol. 2006;24:136–143
  18. Menon M, Hemal AK, Tewari A, et al. The technique of apical dissection of the prostate and urethrovesical anastomosis in robotic radical prostatectomy. BJU Int. 2004;93:715–719
  19. Poore RE, McCullough DL, Jarow JP. Puboprostatic ligament sparing improves urinary continence after radical retropubic prostatectomy. Urology. 1998;51:67–72
  20. Klein EA. Early continence after radical prostatectomy. J Urol. 1992;148:92–95
  21. Eastham JA, Kattan MW, Rogers E, et al. Risk factors for urinary incontinence after radical prostatectomy. J Urol. 1996;156:1707–1713
  22. Stolzenburg JU, Liatsikos EN, Rabenalt R, et al. Nerve sparing endoscopic extraperitoneal radical prostatectomy—effect of puboprostatic ligament preservation on early continence and positive margins. Eur Urol. 2006;49:103–111
  23. Menon M, Tewari AK VIP team. Robotic radical prostatectomy and the Vattikuti Urology Institute technique: an interim analysis of results and technical points. Urology. 2003;61(suppl 1):15–20
  24. Ahlering TE, Eichel L, Edwards RA, et al. Robotic radical prostatectomy: a technique to reduce pT2 positive margins. Urology. 2004;64:1224–1228
  25. Katz R, Salomon L, Hoznek A, et al. Positive surgical margins in laparoscopic radical prostatectomy: the impact of apical dissection, bladder neck remodeling and nerve preservation. J Urol. 2003;169:2049–2052
  26. Epstein JI. Incidence and significance of positive margins in radical prostatectomy specimens. Urol Clin North Am. 1996;23:651–663
  27. Richman M, McLaughlin S, Maygarden S, et al. Initial incision of lateral pelvic fascia and early ligation of vascular pedicles during radical prostatectomy: potential to reduce positive margin rates. BJU Int. 2005;95:40–45
  28. Patel VR, Tully AS, Holmes R, et al. Robotic radical prostatectomy in the community setting—the learning curve and beyond: initial 200 cases. J Urol. 2005;174:269–272

 This study was supported by the Ronald P. Lynch Urologic Oncologic Endowment and Brady Urologic Research Foundation at Cornell University.

PII: S0090-4295(06)02652-5

doi: 10.1016/j.urology.2006.12.028

Urology
Volume 69, Issue 4 , Pages 726-731 , April 2007