Vas deferens urethral support improves early post-prostatectomy urine continence

Urine continence is often impaired after radical prostatectomy. Few randomized studies prove the efficacy of novel surgical approaches. Vas deferens urethral support (VDUS) during robot-assisted laparoscopic prostatectomy (RALP) was studied for improvement of early postoperative urine continence in a single-centre prospective double-blind randomized study with a power of 90% to detect a 30% decrease in early incontinence. 112 men were randomized, and 108 could be analyzed (VDUS n = 54, noVDUS n = 54). VDUS improved early continence by 40% at 1 month (59% vs. 35%, P = 0.02); 6 months postoperatively this was 72% vs. 62%, P = 0.41. A 24-h pad test at 1 day, 3 days, and 1 week showed decreased amounts of urine loss in the VDUS group. The ICIQ-SF score was significantly lower for the VDUS group within the first month after surgery. VDUS had no impact upon quality of life questionnaire analyses for overall and lower urinary tract symptom-related quality of life but showed a significant improvement in the social domain of the EORTC-QLQ-C30 questionnaire. VDUS moderately improved early urine continence within 1 month after RALP.