Skip to main content

Advertisement

SpringerLink
Log in

Early recovery of urinary continence after laparoscopic versus retropubic radical prostatectomy: evaluation of preoperative erectile function and nerve-sparing procedure as predictors

  • Urology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

The aim of this study was to evaluate preoperative erectile function and attempted nerve-sparing procedure as predictors for early recovery of urinary continence after retropubic and laparoscopic radical prostatectomy. Patients were divided into two groups according to surgical approach (retropubic or laparoscopic) and learning curve for laparoscopic approach: group 1—retropubic approach (37 patients operated on from April 2000 to June 2006), group 2—laparoscopic approach (109 patients operated on from April 2003 to June 2006). We assessed state of urinary continence at 1, 3, 6, and 12 months after removal of the urinary catheter. Overall rates of urinary continence were 18%, 49%, 68%, and 80% at 1, 3, 6, and 12 months, respectively. Between groups 1 and 2, no statistically significant differences in recovery of urinary continence were evident, being 27% versus 15% at 1 month, 54% versus 47% at 3 months, 77% versus 65% at 6 months, and 91% versus 77% at 12 months in groups 1 and 2, respectively. An attempted nerve-sparing procedure (one or both neurovascular bundles) was statistically associated with urinary continence at 3 month, and International Index of Erectile Function-5 (IIEF-5) score (≥14) was identified as a significant factor predicting urinary continence at 6 months after laparoscopic radical prostatectomy. Younger age tended to result in early recovery of urinary continence after retropubic radical prostatectomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Walsh PC, Donker PJ (1982) Impotence following radical prostatectomy: insight into etiology and prevention. J Urol 128:492–497

    PubMed  CAS  Google Scholar 

  2. Sacco E, Prayer-Galetti T, Pinto F et al (2006) Urinary incontinence after radical prostatectomy: incidence by definition, risk factors and temporal trend in a large series with a long-term follow-up. BJU Int 97:1234–1241. doi:10.1111/j.1464-410X.2006.06185.x

    Article  PubMed  Google Scholar 

  3. Peyromaure M, Ravery V, Boccon-Gibod L (2002) The management of stress urinary incontinence after radical prostatectomy. BJU Int 90:155–161. doi:10.1046/j.1464-410X.2002.02824.x

    Article  PubMed  CAS  Google Scholar 

  4. Rogers CG, Su LM, Link RE et al (2006) Age stratified functional outcomes after laparoscopic radical prostatectomy. J Urol 176:2448–2452. doi:10.1016/j.juro.2006.07.153

    Article  PubMed  Google Scholar 

  5. Konety BR, Sadetsky N, Carroll PR (2007) Recovery of urinary continence following radical prostatectomy: the impact of prostate volume—analysis of data from the CaPSURE Database. J Urol 177:1423–1425. doi:10.1016/j.juro.2006.11.089

    Article  PubMed  Google Scholar 

  6. Coakley FV, Eberhardt S, Kattan MW et al (2002) Urinary continence after radical retropubic prostatectomy: relationship with membranous urethral length on preoperative endorectal magnetic resonance imaging. J Urol 168:1032–1035. doi:10.1016/S0022-5347(05)64568-5

    Article  PubMed  Google Scholar 

  7. Lee SE, Byun SS, Lee HJ et al (2006) Impact of variations in prostatic apex shape on early recovery of urinary continence after radical retropubic prostatectomy. Urology 68:137–141. doi:10.1016/j.urology.2006.01.021

    Article  PubMed  Google Scholar 

  8. Burkhard FC, Kessler TM, Fleischmann A et al (2006) Nerve sparing open radical retropubic prostatectomy—does it have an impact on urinary continence? J Urol 176:189–195. doi:10.1016/S0022-5347(06)00574-X

    Article  PubMed  Google Scholar 

  9. Kaiho Y, Nakagawa H, Ikeda Y et al (2005) Intraoperative electrophysiological confirmation of urinary continence after radical prostatectomy. J Urol 173:1139–1142. doi:10.1097/01.ju.0000152316.51995.fc

    Article  PubMed  Google Scholar 

  10. Nandipati KC, Raina R, Agarwal A et al (2007) Nerve-sparing surgery significantly affects long-term continence after radical prostatectomy. Urology 70:1127–1130. doi:10.1016/j.urology.2007.07.042

    Article  PubMed  Google Scholar 

  11. Wille S, Heidenreich A, Hofmann R et al (2007) Preoperative erectile function is one predictor for postprostatectomy incontinence. Neurourol Urodyn 26:140–143. doi:10.1002/nau.20314

    Article  PubMed  CAS  Google Scholar 

  12. Jacobsen NE, Moore KN, Estey E et al (2007) Open versus laparoscopic radical prostatectomy: a prospective comparison of postoperative urinary incontinence rates. J Urol 177:615–619. doi:10.1016/j.juro.2006.09.022

    Article  PubMed  Google Scholar 

  13. Hara I, Kawabata G, Miyake H et al (2003) Comparison of quality of life following laparoscopic and open prostatectomy for prostate cancer. J Urol 169:2045–2048. doi:10.1097/01.ju.0000063961.99940.6c

    Article  PubMed  Google Scholar 

  14. Walsh PC (1998) Anatomic radical prostatectomy: evolution of the surgical technique. J Urol 160:2418–2424. doi:10.1016/S0022-5347(01)62202-X

    Article  PubMed  CAS  Google Scholar 

  15. Guillonneau B, Vallancien G (2000) Laparoscopic radical prostatectomy: the Montsouris experience. J Urol 163:418–422. doi:10.1016/S0022-5347(05)67890-1

    Article  PubMed  CAS  Google Scholar 

  16. Rosen RC, Cappelleri JC, Smith MD et al (1999) Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 11:319–326. doi:10.1038/sj.ijir.3900472

    Article  PubMed  CAS  Google Scholar 

  17. Chao R, Mayo ME (1995) Incontinence after radical prostatectomy: detrusor or sphincter causes. J Urol 154:16–18. doi:10.1016/S0022-5347(01)67212-4

    Article  PubMed  CAS  Google Scholar 

  18. Majoros A, Bach D, Keszthelyi A et al (2006) Urinary incontinence and voiding dysfunction after radical retropubic prostatectomy (prospective urodynamic study). Neurourol Urodyn 25:2–7. doi:10.1002/nau.20190

    Article  PubMed  Google Scholar 

  19. Hammerer P, Huland H (1997) Urodynamic evaluation of changes in urinary control after radical retropubic prostatectomy. J Urol 157:233–236. doi:10.1016/S0022-5347(01)65334-5

    Article  PubMed  CAS  Google Scholar 

  20. Moinzadeh A, Shunaigat AN, Libertino JA (2003) Urinary incontinence after radical retropubic prostatectomy: the outcome of a surgical technique. BJU Int 92:355–359. doi:10.1046/j.1464-410X.2003.04348.x

    Article  PubMed  CAS  Google Scholar 

  21. Rassweiler J, Seemann O, Schulze M et al (2003) Laparoscopic versus open radical prostatectomy: a comparative study at a single institution. J Urol 169:1689–1693. doi:10.1097/01.ju.0000062614.56629.41

    Article  PubMed  Google Scholar 

  22. Kundu SD, Roehl KA, Eggener SE et al (2004) Potency, continence and complications in 3,477 consecutive radical retropubic prostatectomies. J Urol 172:2227–2231. doi:10.1097/01.ju.0000145222.94455.73

    Article  PubMed  Google Scholar 

  23. Rassweiler J, Sentker L, Seemann O et al (2001) Laparoscopic radical prostatectomy with the Heilbronn technique: an analysis of the first 180 cases. J Urol 166:2101–2108. doi:10.1016/S0022-5347(05)65514-0

    Article  PubMed  CAS  Google Scholar 

  24. Sullivan ME, Keoghane SR, Miller MA (2001) Vascular risk factors and erectile dysfunction. BJU Int 87:838–845. doi:10.1046/j.1464-410x.2001.02211.x

    Article  PubMed  CAS  Google Scholar 

  25. Breza J, Aboseif SR, Orvis BR et al (1989) Detailed anatomy of penile neurovascular structures: surgical significance. J Urol 141:437–443

    PubMed  CAS  Google Scholar 

  26. Healy J, Borley N, Mundy A (2005) Male urethra. Gray’s Anatomy, 39th edn. Churchill Livingstone, London

    Google Scholar 

  27. John H, Suter S, Hauri D (2002) Effect of radical prostatectomy on urethral blood flow. Urology 59:566–569. doi:10.1016/S0090-4295(01)01653-3

    Article  PubMed  Google Scholar 

  28. John H, Hauri D, Leuener M et al (2001) Evidence of trigonal denervation and reinnervation after radical retropubic prostatectomy. J Urol 165:111–113. doi:10.1097/00005392-200101000-00028

    Article  PubMed  CAS  Google Scholar 

  29. Strasser H, Klima G, Poisel S et al (1996) Anatomy and innervation of the rhabdosphincter of the male urethra. Prostate 28:24–31. doi :10.1002/(SICI)1097-0045(199601)28:1<24::AID-PROS4>3.0.CO;2-O

  30. Akita K, Sakamoto H, Sato T (2003) Origins and courses of the nervous branches to the male urethral sphincter. Surg Radiol Anat 25:387–392. doi:10.1007/s00276-003-0151-9

    Article  PubMed  CAS  Google Scholar 

  31. Takenaka A, Tewari A, Hara R et al (2007) Pelvic autonomic nerve mapping around the prostate by intraoperative electrical stimulation with simultaneous measurement of intracavernous and intraurethral pressure. J Urol 177:225–229. doi:10.1016/j.juro.2006.08.104

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuou-ku, Kobe, Japan

    Atsushi Takenaka, Hideo Soga, Toshifumi Kurahashi, Hideaki Miyake, Kazushi Tanaka & Masato Fujisawa

Authors
  1. Atsushi Takenaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hideo Soga
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Toshifumi Kurahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hideaki Miyake
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kazushi Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Masato Fujisawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Atsushi Takenaka.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Takenaka, A., Soga, H., Kurahashi, T. et al. Early recovery of urinary continence after laparoscopic versus retropubic radical prostatectomy: evaluation of preoperative erectile function and nerve-sparing procedure as predictors. Int Urol Nephrol 41, 587–593 (2009). https://doi.org/10.1007/s11255-008-9480-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-008-9480-2

Keywords

Search

Navigation