Radical prostatectomy: bladder neck preservation and puboprostatic ligament sparing—effects on continence and positive margins

Abstract Objectives To determine the effect of puboprostatic ligament sparing and bladder neck preservation on postoperative continence and positive margins after radical retropubic prostatectomy. Methods A total of 149 men with clinically localized prostate cancer underwent radical retropubic prostatectomy. A bladder neck preservation technique was used in 48 patients (group 1), puboprostatic ligament sparing in 51 patients (group 2), and both techniques in 50 men (group 3). Urinary continence and margin status were assessed. Results A statistically significant difference in the early return of continence was found 3 and 6 months postoperatively between groups 1 and 2 ( P P Conclusions The final continence rates did not differ among the three groups. However, bladder neck preservation offered an earlier return of continence compared with the puboprostatic ligament-sparing technique. The positive margin status was similar for all three groups.