Effect of bladder neck preservation on urinary continence in endoscopic extraperitoneal radical prostatectomy

Objective To assess the feasibility,efficacy and safety of bladder neck preservation (BNP) in endoscopic extraperitoneal radical prostatectomy (EERP),and evaluate the influence on postoperative early continence.Methods Preoperative data,operative time,blood lose,pathological staging,margin status and early continence status from 34 BNP and 38 standard technique (ST) in EERP were retrospectively assessed.Urinary incontinence was evaluated based on the NCI Common Toxicity Criteria (version 2).Grade 0 is defined as no incontinence; Grade 1 incontinence occurs with coughing,sneezing,or laughing; Grade 2 is spontaneous incontinence with some control; and Grade 3 is no control.Number of daily pads usage were also used to measure urinary incontinence.0-1 pad/day was defined as urinary continence,2-3 pads/day was defined as mild incontinence,＞ 3 pads/day was defined as incontinence.Results Both groups were similar in age,body mass index,prostate volume,prostate-specific antigen and Gleason score (P ＞ 0.05).There was no significant difference in operative time,blood loss,catheter removal time,postoperative hospital stay,and postoperative PSA levels (P ＞ 0.05).There were 4 cases of positive margin in BNP and ST groups respectively.There were 2 cases of urine leakage in BNP group,and 6 in ST group.The cases of grade 0 in BNP group in first day,1 week,1 month and 3 months after catheter removal were3 (8.8％),9 (26.5％),16 (47.1％),24 (70.6％).The cases of 0-1 pad/day were7 (20.6％),12 (35.3％),22 (64.7％),28 (82.4％),respectively.The cases of grade 0 in ST group in first day,1 week,1 month and 3 months after catheter removal were 1 (2.6％),2 (5.3％),5 (13.2％),13 (34.2％).The eases of 0-1 pad/day were2 (5.3％),5 (13.2％),10 (26.3％),20 (52.6％),respectively.There were significant differences in postoperative early continence between BNP and ST groups (P ＜ 0.05).Conclusion EERP with BNP could be feasible and safe,with a positive impact on postoperative early continence. Key words: Prostatic neoplasms ;  Prostatectomy ;  Laparoscopes ;  Bladder neck preservation ; Urinary continence