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Tubularized neourethra following radical retropubic prostatectomy
M S Steiner1, A L Burnett, J D Brooks
1Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
The Journal of Urology
|August 1, 1993
Summary
Creating a tubularized neourethra during bladder neck reconstruction after prostatectomy significantly improves urinary continence. This surgical technique aids in the early return of urinary control for patients.
Area of Science:
- Urology
- Oncology
- Surgical Innovation
Background:
- Radical retropubic prostatectomy for localized prostate cancer can lead to urinary incontinence.
- Restoring urinary continence after prostatectomy is a significant challenge for patients and surgeons.
Purpose of the Study:
- To evaluate the efficacy of a tubularized neourethra using an anterior bladder flap in improving postoperative urinary continence.
- To compare continence rates in patients who underwent radical retropubic prostatectomy with and without neourethra formation.
Main Methods:
- A 1.5 cm tubularized neourethra was created using an anterior bladder flap in 69 patients undergoing radical retropubic prostatectomy.
- Postoperative urinary continence was assessed by history at 3 and 6 months.
- Continence outcomes were compared to a control group of 45 patients who did not have neourethra formation.
Main Results:
- At 3 months, 55% of the study group were continent versus 31% in the control group (p < 0.03).
- At 6 months, continence rates were 87% in the study group compared to 47% in the control group (p < 0.01).
- Cystograms suggested the neourethra may enhance resistance proximal to the external sphincter.
Conclusions:
- Tubularized neourethra formation using an anterior bladder flap is an effective technique for improving urinary continence after radical retropubic prostatectomy.
- This method may facilitate an earlier return of urinary control by increasing resistance near the external sphincter.