The role of preserving the inner sphincter mechanism and the bladder neck in the early achieving urine continence when performing radical retropubic prostatectomy

Opis

Objective: To assess the effect of preserving the internal sphincter on urine continence in patients who have gone through radical prostatectomy due to prostate cancer. Materials and methods: Open retropubic prostatectomy has been performed on 69 patients in our Urology department, of whom 44 patients were treated with careful preservation of the internal sphincter mechanism on the bladder neck, and a control group of 25 patients who didn’t have preserved internal sphincter. Retrospectively, we used the standardized international questionnaires, ICIQ-UI-SF and IIEF-5, which were translated and adapted. All of the patients were operated in the period 2014-2015. Results: Patients who had preserved inner sphincter mechanism and bladder neck during their radical prostatectomy, achieved continence much sooner, but the rate of continence in both groups after 12 months remained unchanged. The grade of incontinence till the 9-th month postoperatively was evidently lower in the examined group. The rate of anastomotic stricture and erectile dysfunction remained unchanged. Conclusion: The remains of the internal sphincter makes passive closing mechanism that helps the continence in the patients till the distal sphincter takes over the control which happens much later in the postoperative period. Key words: Incontinence, radical prostatectomy, inner sphincte