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Improved urinary continence after radical retropubic prostatectomy with preparation of a long, partially intraprostatic portion of the membraneous urethra: an analysis of 1013 consecutive cases

Prostate Cancer and Prostatic Diseases volume 7, pages 253–257 (2004)Cite this article

Abstract

Purpose: To improve the rate of full continence in our patients, we performed, since June 1997, a careful preparation of the distally intraprostatic part of the membranous urethra to obtain a long urethral stump for the vesicourethral anastomosis.

Patients and methods: In all, 610 patients without (group 1) and 403 patients with (group 2) a long intraprostatic stump of the urethra were asked by a self-administered questionnaire about their continence status. The rate of positive surgical margins were compared as a marker of local tumour control.

Results: Full continence (no pads) was achieved in 76.02% in group 1 and in 88.84%, of all patients in group 2. Stress incontinence (SIC) I° was found in 12.46% and 7.44% respectiveley, SIC II° was noted in 8.69 and 3.72% and complete incontinence was seen in 2.79% in group 1 and in two patients (0.5%) in group 2. Also the time to reach the final continence status was statistically and highly significantly (P<0.001) shortened. The rate of positive margins decreased in group 2, despite intraprostatic preparation.

Conclusions: The preparation of a long, partially intraprostatic portion of the membranous urethra for vesicourethral anastomosis in radical retropubic prostatectomy leads to a statistically highly significant improvement of full continence and earlier continence in prostate cancer patients without compromising local tumour control.

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Authors and Affiliations

  1. Department of Urology, Technische Universität Munich, Munich, Germany

    H van Randenborgh, R Paul, H Kübler, J Breul & R Hartung

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  1. H van Randenborgh
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  2. R Paul
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  3. H Kübler
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  4. J Breul
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  5. R Hartung
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Correspondence to H van Randenborgh.

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van Randenborgh, H., Paul, R., Kübler, H. et al. Improved urinary continence after radical retropubic prostatectomy with preparation of a long, partially intraprostatic portion of the membraneous urethra: an analysis of 1013 consecutive cases. Prostate Cancer Prostatic Dis 7, 253–257 (2004). https://doi.org/10.1038/sj.pcan.4500726

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