Early continence after radical prostatectomy: A systematic review

Area of Science:

• Urology
• Surgical Oncology
• Reconstructive Surgery

Background:

• Urinary incontinence significantly affects quality of life post-radical prostatectomy.
• Preserving urinary continence is a critical challenge after prostate cancer surgery.

Purpose of the Study:

• To review current evidence on surgical techniques for preserving urinary continence after radical prostatectomy.
• To analyze variations in surgical approaches aimed at improving post-prostatectomy continence.

Main Methods:

• Systematic literature search using PRISMA guidelines on PubMed, Cochrane, and ScienceDirect.
• Inclusion of randomized clinical trials and meta-analyses focusing on urinary continence after radical prostatectomy.
• Analysis of surgical techniques including bladder neck preservation and rhabdosphincter reconstruction.

Main Results:

• Bladder neck and neurovascular bundle preservation, and rhabdosphincter reconstruction are key techniques for early urinary continence.
• Rhabdosphincter reconstruction has demonstrated improved functional outcomes in randomized trials.
• Lack of consensus on incontinence definition and measurement hinders evidence-based recommendations.

Conclusions:

• Rhabdosphincter reconstruction is the only technique with demonstrated functional improvements in randomized trials.
• Current evidence is limited and heterogeneous, necessitating further research.
• More studies with consistent criteria are required to establish a standard surgical technique for urinary continence preservation.