Application and Efficacy of Pubovesical Complex Preserving Technique During Laparoscopic Radical Prostatectomy

Urinary incontinence and Erectile function are two hot issues after radical prostatectomy. This study aims to explore the application and curative effect of “pubovesical complex preserving technique for intrafascial laparoscopic radical prostatectomy (PPLRP)”. Methods: This was a retrospective study of 200 patients who underwent laparoscopic radical prostatectomy (LRP) from January 2011 to May 2018. Results: During the study period, we collected 68 patients with PPLRP in group A, 46 patients with conventional intrafascial LRP in group B and 86 patients with interfascial LRP in group C, respectively. Three groups had no difference in terms of Preoperative age, Clinical stage, Prostate-specific antigen (PSA) value, Gleason score at biopsy and Preoperative good potency (IIEF-5 score) (P>0.05). There was no difference between the three groups in terms of operative time, intraoperative blood loss, time of catheter retain, postoperative stay and histologic status. All groups had similar PSM (positive surgical margin, PSM) rate. Continence rates at immediately after catheter removal, 1,3 and 6 months: 68% (46/68),85% (58/68),93% (63/68) and 100% (68/68) in group A; and 63% (29/46),80% (37/46),89% (41/46) and 96% (44/46) in group B; and 22% (19/63),49% (42/63),72% (62/63) and 84% (72/63) in group C. Regarding sexual function: No differences were found in the three groups in potency (IIEF-5 score). Baseline IIEF-score reached 50%,35% and 21% respectively at postoperative 6 months. Biochemical recurrence-free survival at 3 years was 79.3%,76.3% and 76.4% in A, B and C group, respectively. Conclusions: The PVC preserving technique for LRP provides early recovery from incontinence, faster recovery of sexual function preoperative levels. There is no adverse effect on the oncological outcome in the selective prostate cancer. It is an ideal way of nerve-sparing LRP.