Bladder Neck Preservation during Radical Prostatectomy Needed for Recovery of Continence in Elderly Men (>70 years)

Yu YD, Kang MH, Choi KH, Oh JJ and Park DS

Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea

^*Correspondance to: Dong Soo Park 

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Abstract:

Purpose: To determine the influence of bladder neck preservation (BNP) on postoperative continence and positive bladder neck surgical margin rates.
Materials and Methods: Total 321 patients over 70 years with localized prostate cancer underwent robot assisted laparoscopic prostatectomy (RALP), with 163 men undergoing standard bladder neck dissection (group 1) and 168 undergoing BNP (group 2). Group 1 patients received standard RALP techniques with Ven velthoven continuous suturing for urethrovesical anastomosis and group 2 patients received both standard RALP techniques and lateral bladder neck dissection. Pre- and postoperative urinary function and continence recovery were evaluated and compared between the two groups.
Results: The overall positive margin rate was 4.9% in group 1 and 12.5% in group 2, indicating a greater positive surgical margin rate with statistical significance in the bladder neck preservation group (p=0.045). Postoperative continence was evaluated by EPIC short form questionnaire and at 1 and 4 months postoperatively, the mean urinary function scores were higher in group 2 compared to group 1 with statistical significance (p=0.021 at 1month, p=0.043 at 4 months). Group 2 showed significantly higher continence rates at 1 and 4 months post-RALP than group 1. (p<0.001 at 1month, p=0.003 at 4 months). In group 2, the recovery of continence approached to 91.3% at 4 months post-operation showing early return of continence was observed in the patients with bladder neck preservation. Conclusions: In healthy elderly patients, early recovery of postoperative continence and urinary functions after RALP can be achieved by bladder neck preservation.

Keywords:

Prostate; Urinary bladder; Prostatectomy; Urinary incontinence

Cite the Article:

Yu YD, Kang MH, Choi KH, Oh JJ, Park DS. Bladder Neck Preservation during Radical Prostatectomy Needed for Recovery of Continence in Elderly Men (>70 years). Clin Oncol. 2016; 1: 1004.