AB010. “Total reconstruction” of the urethrovesical anastomosis contributes to early urinary continence in laparoscopic radical prostatectomy

Background To improve early recovery of continence after radical prostatectomy, we present our experience with total reconstruction in urethrovesical anastomosis after extraperitoneal laparoscopic radical prostatectomy (ELRP). Methods ELRP was performed using a standard urethrovesical anastomosis in 79 consecutive patients (group A) from June 2011 to October 2012, and using a total reconstruction procedure in 82 consecutive patients (group B) from June 2012 to June 2013. The primary outcome measure was urinary continence assessed at 1, 2, 4, 12, 24 and 52 weeks after catheter removal. Other data recorded were patient age, body mass index (BMI) (kg/m2), International Prostate Symptoms Score (IPSS), prostate volume, preoperative PSA, Digital Rectal Examination (DRE) for T stage evaluation, Gleason score, neurovascular bundle preservation, operation time, blood loss, complications and positive margin rate. Results In group A the continence rates at 1, 2, 4, 12, 24 and 52 weeks were 7.59%, 20.25%, 37.97%, 58.22%, 81.01% and 89.87% respectively. In group B the continence rates were 13.41%, 32.92%, 65.85%, 81.71%, 90.24% and 95.12% respectively. Group B had significantly higher continence rates at 4 and 12 weeks after ERLP (P<0.001 and P=0.001). There were no significant differences between the groups with respect to patients age, BMI, prostate-specific antigen level, prostate volume, IPSS, estimated blood loss, number of nerve-sparing procedures and postoperative complications. Conclusions Total reconstruction of the urethrovesical anastomosis during ELRP improved early recovery of continence.