Bladder Neck Preservation following Radical Prostatectomy: Continence and Margins

The Impact of Urinary Extravasation after Radical Retropubic Prostatectomy on Urinary Incontinence and Anastomotic Strictures

“…Similar data were reported by Gaker et al [9], who found no correlation between the degree of extravasation and the degree of incontinence. Braslis et al [13] suggest that preserving bladder neck and proximal prostatic urethra may improve continence and/ or aid in the earlier recovery of continence.…”

“…Postoperative anastomotic strictures are primarily caused by the inadequate approximation of the mucosa of the urethral stent to the everted mucosa of the bladder neck and by insufficient reconstruction of the bladder neck. Over the past few years, several authors reported on modifications of bladder neck reconstruction to improve postoperative continence and to decrease the risk of anastomotic strictures [1,8,9,13].…”

Analysis of Risk Factors for Urinary Incontinence after Radical Prostatectomy

“…Some studies dealing with postprostatectomy incontinence focused on urodynamic factors being responsible for incontinence [5][6][7][8] , whereas others tried to analyze the impact of the pre-and perioperative factors ( table 1 ) on urinary incontinence [2][3][4][9][10][11][12][13][14][15][16][17] . Some of the authors showed no association between the above-mentioned factors and postoperative incontinence [2, 11-13, 15, 17] , while others believed that older age, lack of a nerve-sparing technique, presence of anastomotic stricture, bladder neck resection and creating vesicourethral anastomosis without a long, partially intraprostatic portion of the urethra could be responsible for incontinence or at least represent risk factors delaying continence [1,3,4,9,10,14,16,[18][19][20][21] . Univariate analysis was used in the majority of these studies in order to determine the risk factors related to incontinence.…”

Improving Bladder Neck Division in Radical Retropubic Prostatectomy by prior Dissection of the Seminal Vesicles and Vasa deferentia

“…This means that subsequent division of the bladder neck is easy, fast and results in less bleeding of the posterior wall. Some teams preserve the bladder neck [4][5][6] but, because we use the tape as a guide, the diameter of the bladder neck opening is small and there is no need to reconstruct the bladder neck, thus facilitating urethrovesical anastomosis.…”