Posterior Reconstruction of the Rhabdosphincter Allows a Rapid Recovery of Continence after Transperitoneal Videolaparoscopic Radical Prostatectomy

ObjectivesUrinary incontinence is one of the major drawbacks of radical retropubic prostatectomy (RRP). One of the possible reasons for this urinary incontinence is a postoperative deficiency of the rhabdosphincter (RS). It has been recently demonstrated that reconstruction of the posterior aspects of the RS allows a rapid recovery of continence after RRP. This study evaluated the application of this technique in videolaparoscopic radical prostatectomy (VLRP), assessing the percentage of continent patients at 3, 30, and 90 d after catheter removal.MethodsA two-arm prospective comparative trial was carried out with 31 patients recruited for each arm. Group A underwent standard VLRP and group B underwent VLRP with RS reconstruction (VLRP-R). Continence was defined as no pads or one diaper/24 h and was assessed 3, 30, and 90 d after the procedure.ResultsAt catheter removal, 74.2% versus 25% (p = 0.0004) of patients were continent with the VLRP-R technique versus VLRP, respectively. A statistically significant difference was present at 30 d (83.8% vs. 32.3%; p = 0.0001) At 90 d the difference, although still present, was not statistically significant (92.3% vs. 76.9%; p = 0.25).ConclusionsIn this preliminary report, the posterior reconstruction of the RS appears to be an easy and feasible technique even in a laparoscopic setting. Time to continence recovery was significantly shortened.