Open Access

Utility of transrectal ultrasonography guidance and seven key elements of operative skill for early recovery of urinary continence after laparoscopic radical prostatectomy

  • Authors:
    • Haruhito Azuma
    • Naokazu Ibuki
    • Teruo Inamoto
    • Kohei Koyama
    • Shinya Utimoto
    • Yutaka Fujisue
    • Yoichi Mizutani
    • Hayahito Nomi
    • Takanobu Ubai
    • Yoji Katsuoka
  • View Affiliations

  • Published online on: December 7, 2010     https://doi.org/10.3892/ijo.2010.865
  • Pages: 293-304
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Abstract

In the present study, we report the utility of transrectal ultrasonography guidance for laparoscopic radical prostatectomy (LRP), and the effect of a novel surgical approach of ‘seven key elements of operative skill for the early recovery of urinary continence’ (‘7 key elements’). Among 170 patients who underwent laparoscopic prostatectomy between July 2007 and June 2010, 72 were treated on the basis of these 7 key elements (group 1), which included the preservation of 1) endopelvic fascia, 2) bladder neck, 3) pelvic nerve, 4) membranous urethra, 5) urethral sphincter and fixation of the organ positioning with 6) bladder neck sling suspension, and 7) restoration of the Denonvilliers' fascia, while the remaining 98 were not (group 2). We compared the data for the two groups with regards to the time taken for recovery of continence, and post-operative course. Application of the 7 key elements led to significantly earlier recovery of continence. In group 1, the number of urinary pads used after surgery was significantly reduced at all of the examined time-points after surgery (1, 3, 6 and 12 months) (p<0.0001). In group 1, more than half of the patients (54%) achieved urinary continence within 3 months, 93% achieved it within 6 months, and all patients had achieved it within 12 months after surgery. However, in group 2, <10% of the patients (8.5%, p<0.0001) achieved continence within 3 months, and 23% (P<0.0001) achieved it within 6 months. Therefore, the results show that the 7 key elements of operative skill with transrectal ultrasonography guidance significantly improve the outcome of LRP, reducing the time required for the recovery of continence.

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February 2011
Volume 38 Issue 2

Print ISSN: 1019-6439
Online ISSN:1791-2423

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Spandidos Publications style
Azuma H, Ibuki N, Inamoto T, Koyama K, Utimoto S, Fujisue Y, Mizutani Y, Nomi H, Ubai T, Katsuoka Y, Katsuoka Y, et al: Utility of transrectal ultrasonography guidance and seven key elements of operative skill for early recovery of urinary continence after laparoscopic radical prostatectomy. Int J Oncol 38: 293-304, 2011.
APA
Azuma, H., Ibuki, N., Inamoto, T., Koyama, K., Utimoto, S., Fujisue, Y. ... Katsuoka, Y. (2011). Utility of transrectal ultrasonography guidance and seven key elements of operative skill for early recovery of urinary continence after laparoscopic radical prostatectomy. International Journal of Oncology, 38, 293-304. https://doi.org/10.3892/ijo.2010.865
MLA
Azuma, H., Ibuki, N., Inamoto, T., Koyama, K., Utimoto, S., Fujisue, Y., Mizutani, Y., Nomi, H., Ubai, T., Katsuoka, Y."Utility of transrectal ultrasonography guidance and seven key elements of operative skill for early recovery of urinary continence after laparoscopic radical prostatectomy". International Journal of Oncology 38.2 (2011): 293-304.
Chicago
Azuma, H., Ibuki, N., Inamoto, T., Koyama, K., Utimoto, S., Fujisue, Y., Mizutani, Y., Nomi, H., Ubai, T., Katsuoka, Y."Utility of transrectal ultrasonography guidance and seven key elements of operative skill for early recovery of urinary continence after laparoscopic radical prostatectomy". International Journal of Oncology 38, no. 2 (2011): 293-304. https://doi.org/10.3892/ijo.2010.865