Efficacy of Modified Extraperitoneal Laparoscopic Intrafascial Radical Prostatectomy in Prostate Cancer and Analysis...

This study was designed to expound the efficacy of a modified extraperitoneal laparoscopic radical prostatectomy (ELRP) technique involving total intrafascial resection with the standard interfascial nerve-sparing technique in patients with prostate cancer (PC), and to identify factors influencing postoperative urinary continence recovery following the modified procedure. Phase 1: A retrospective analysis compared modified (n = 100) vs. standard ELRP (n = 100) for surgical outcomes, urodynamics, erectile function, and continence recovery. Phase 2: Analysis of 400 modified ELRP patients identified independent continence recovery risk factors via logistic regression (poor-continence: n = 63; good-continence: n = 337). At 6 months, the modified group showed greater urodynamic improvement (p < 0.05). Erectile function and continence were comparable at 1/3 months but better in the modified group at 6 months (p < 0.05). Age ≥ 65 years, BMI ≥ 24.0 kg/m², TURP history, prostate volume ≥ 30 cm³, preserved urethral length ≤ 5 cm, and absence of regular pelvic floor exercises were associated with postoperative continence recovery in PC patients (p < 0.05). Modified ELRP provides favorable oncological and functional outcomes in PC patients. Several patient- and surgery-related factors were associated with postoperative urinary continence recovery.