An anterior urethral stitch improves urinary incontinence following radical prostatectomy

Objective: To determine the effects of an anterior urethral stitch, referre d to as an endopelvic anterior urethral stitch (EAUS), in reducing recovery time for post-prostatectomy urinary incontinence. Methods: The urinary continence recovery time for 24 patients, who received a retropubic radical prostatectomy with the EAUS procedure, was compared t o that of a historical control series of 22 patients without EAUS. The EAUS is a simple 2-0 polyglactin stitch placed between the bunched dorsal vein complex and the anterior urethra. This procedure was performed at the time of urethro-vesical anastomosis. Continence recovery time was defined as the day after removal of the urethral catheter when the patient no longer requ ired pads for incontinence. Results: A significantly shorter time for continence recovery (median 8.5 d ays) was obtained in EAUS patients compared with that of the control series (median 72 days) (P < 0.0001). Early recovery of continence was observed i n 12/24 patients (50%) within 1 week and 18/24 patients (75%) within 1 mont h in EAUS patients. No adverse effects or complications were observed in th e EAUS patients. Conclusion: A surgical procedure, the EAUS, has been developed that reduces urinary incontinence in patients who have undergone a radical prostatectom y. This procedure is simple and quick and improves recovery of continence w ithout any side-effects.