Nerve sparing open radical retropubic prostatectomy--does it have an impact on urinary continence?

Burkhard, Fiona C; Kessler, Thomas M; Fleischmann, Achim; Thalmann, George N; Schumacher, Martin; Studer, Urs E (2006). Nerve sparing open radical retropubic prostatectomy--does it have an impact on urinary continence? Journal of urology, 176(1), pp. 189-95. New York, N.Y.: Elsevier 10.1016/S0022-5347(06)00574-X

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PURPOSE: We prospectively assessed the role of nerve sparing surgery on urinary continence after open radical retropubic prostatectomy. MATERIALS AND METHODS: We evaluated a consecutive series of 536 patients who underwent open radical retropubic prostatectomy with attempted bilateral, unilateral or no nerve sparing, as defined by the surgeon, without prior radiotherapy at a minimum followup of 1 year with documented assessment of urinary continence status. Because outlet obstruction may influence continence rates, its incidence and management was also evaluated. RESULTS: One year after surgery 505 of 536 patients (94.2%) were continent, 27 (5%) had grade I stress incontinence and 4 (0.8%) had grade II stress incontinence. Incontinence was found in 1 of 75 (1.3%), 11 of 322 (3.4%) and 19 of 139 patients (13.7%) with attempted bilateral, attempted unilateral and without attempted nerve sparing, respectively. The proportional differences were highly significant, favoring a nerve sparing technique (p <0.0001). On multiple logistic regression analysis attempted nerve sparing was the only statistically significant factor influencing urinary continence after open radical retropubic prostatectomy (OR 4.77, 95% CI 2.18 to 10.44, p = 0.0001). Outlet obstruction at the anastomotic site in 33 of the 536 men (6.2%) developed at a median of 8 weeks (IQR 4 to 12) and was managed by dilation or an endoscopic procedure. CONCLUSIONS: The incidence of incontinence after open radical retropubic prostatectomy is low and continence is highly associated with a nerve sparing technique. Therefore, nerve sparing should be attempted in all patients if the principles of oncological surgery are not compromised.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Urology
04 Faculty of Medicine > Service Sector > Institute of Pathology

UniBE Contributor:

Burkhard, Fiona C.; Kessler, Thomas M.; Fleischmann, Achim; Thalmann, George and Studer, Urs

ISSN:

0022-5347

ISBN:

16753399

Publisher:

Elsevier

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:46

Last Modified:

06 Dec 2013 13:42

Publisher DOI:

10.1016/S0022-5347(06)00574-X

PubMed ID:

16753399

Web of Science ID:

000238298000046

URI:

https://boris.unibe.ch/id/eprint/19255 (FactScience: 1750)

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