Open complete intrafascial nerve-sparing retropubic radical prostatectomy: technique and initial experience

Area of Science:

• Urology
• Oncologic Surgery
• Prostate Cancer Treatment

Background:

• Radical prostatectomy is a standard treatment for localized prostate cancer.
• Preservation of neurovascular bundles and fascial structures is crucial for functional outcomes.
• Refinements in surgical technique aim to improve continence and potency post-prostatectomy.

Purpose of the Study:

• To detail the refined technique of open intrafascial retropubic radical prostatectomy (OIF-RP).
• To evaluate the functional outcomes (continence and potency) at 1-year follow-up.
• To assess the oncological safety and feasibility of the OIF-RP technique.

Main Methods:

• A prospective study of 231 patients with clinically localized prostate cancer undergoing OIF-RP.
• Inclusion criteria: good potency (IIEF-5 score ≥ 15), Gleason score ≤ 6, PSA ≤ 10, clinical T1-2 tumors.
• Surgical technique involved preserving endopelvic fascia, freeing the prostate capsule while keeping periprostatic fasciae/nerves intact.

Main Results:

• 86% of patients achieved full continence by 12 months post-surgery.
• 78% regained baseline erectile function by 12 months.
• No postoperative complications or reinterventions were reported; oncological outcomes were comparable to standard RP.

Conclusions:

• OIF-RP is a viable surgical option for selected prostate cancer patients.
• Preserving periprostatic fasciae and nerves facilitates early recovery of continence and preserves potency.
• The technique balances oncological control with improved functional outcomes.