TUBULARIZED NEOURETHRA FOLLOWING RADICAL RETROPUBIC PROSTATECTOMY

A 1.5 cm. tubularized neourethra was formed using an anterior bladder flap as part of bladder neck reconstruction after radical retropubic p rostatectomy in 69 consecutive patients with clinically localized pros tate cancer (study group). Postoperative continence (defined as requir ing no protection for any activity) was assessed by history at 3 month s (all men) and 6 months (45 of 69 men). Continence in the study group was compared to that of 45 men with 6 months of followup who underwen t radical retropubic prostatectomy without tubularization of the anter ior bladder (control group). At 3 months 38 of 69 men (55%) were conti nent in the study group and 14 of 45 (31%) were continent in the contr ol group (p < 0.03). At 6 months 39 of 45 men (87%) were continent in the study group compared to 21 of 45 (47%) in the control group (p < 0 .01). Upright cystograms performed on men with and without the tubular ized neourethra after radical retropubic prostatectomy suggest that a neourethra proximal to the external sphincter may increase resistance in this area and result in early return of urinary control in men unde rgoing radical retropubic prostatectomy.