[Prophylaxis of urine incontinence in prostatic cancer patients after radical prostatectomy]

We made a multivariate analysis of efficacy of different techniques of radical retropubic prostatectomy (RRP) for prevention of postoperative urine incontinence. A total of 226 patients operated (RRP) in the urological clinic of the Medical University from September 1998 to March 2004 were examined before and after the operation and followed up for 12-46 months. Complete urine retention in the postoperative period after removal of urethral catheter was achieved in 42% patients. By classification of F. Coakly (2002), complete urine retention 1 year after RRP (type 1) was registered in 189 (83.6%) patients. Urine incontinence (UI) of type 2 was observed in 18 (8%) patients, UI of type 3--in 8 (3.5%), of type 4--in 6 (2.7%) patients, total UI was in 5 (2.2%) patients. Earlier restoration of urine retention can be achieved if the surgeon uses careful isolation of apical urethra, saved puboperineal fibers m. levator ani, urinary bladder cervix, special technique of creation of the urethrovesical anastomosis. One year after RRP, 96% operated patients were satisfied with surgical outcomes. Thus, updating RRP technique radically improved treatment outcomes and, therefore, quality of life for patients with prostatic cancer. Nerve- and sphincter-saving, ablastic variant of this surgery is now widely applied in the world and is a method of choice for treatment of patients with prostatic cancer without extracapsular invasion.