Abstract
Objective
Sparing of puboprostatic ligaments (PPLs) during radical prostatectomy was introduced as a technique to improve urinary continence. This study aims to study the effect of sparing of PPLs during laparoscopic radical prostatectomy in terms of continence during the first 3 months.
Methods
A total of 74 patients, diagnosed with clinically localized prostate cancer, were randomly assigned to two equal groups; PPLs division and sparing during LRP. Based on the number of daily used pads, both groups completed 3 months follow-up to assess continence recovery. The effects of age, preoperative total prostate-specific antigen (PSA) and clinical tumor stage on continence recovery were also studied. The study was registered and approved by the Ethics Committee of Alexandria University-Faculty of Medicine (Protocol No. 0201074).
Results
Seventy-four patients were enrolled, with a mean age of 63.8 years. Baseline characteristics were comparable, except significantly higher mean PSA in the division group. Sixty patients were continent (0–1 pad/day) at 3 months follow-up. Continence was significantly better in the sparing than division group at 1 week after catheter removal (67.6% vs 40.5%, p = 0.01), at 1 month (73% vs 45.9%, p = 0.009) and 2 months (89.2% vs 51.4%, p = 0.0001). At 3 months follow-up, there was no significant difference between both groups (83.3% vs 78.4% for sparing and division groups, respectively; p = 0.28). Moreover, continence was significantly improved at 3 months compared to 1 week in both groups.
Conclusion
Sparing of puboprostatic ligaments during radical prostatectomy significantly improves postoperative early recovery of urinary continence.
Ethical approval
Approved by the Ethics committee of Faculty of Medicine, Alexandria University, Egypt. (IRB No. 00012098, FWA No. 00018699, protocol No. 0201074).
Informed consent
All patients consented to participate in the study and to data publication after appropriate information through institutional consent.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Data availability statement
Data collection was done in our center and protected by patient confidentiality.