Relationship between preoperative membranous urethral length and recovery of urinary continence after laparoscopic radical prostatectomy

Abstract

Objective To discuss whether recovery of urinary continence after laparoscopic radical prostatectomy is associated with membranous urethral length.Methods Fifty cases with pathologic confirmed prostate carcinoma were performed laparoscopic radical prostatectomy by a single surgeon.Patients were categorized into two groups according to membranous urethral length (MUL) on preoperative magnetic resonance imaging (Group A:MUL ＜ 14 mm; Group B:MUL ≥ 14 mm).The MUL was measured on coronal images as the distance from the prostatic apex to the entry of the urethra into the penile bulb.After surgery we recorded and analyzed recovery of urinary continence of patients at one-year post operation.In the 50 patients,The mean membranous urethral length was 14.6 (10.2-23.5) mm by MRI.Results All patients completed operation successfully.Three months after surgery,group A had 77.8％ patients and group B had 45.6％ were completely continent (P ＜ 0.05).Six months after surgery,the continence rate was 85.2％ and 69.6％ (P ＞ 0.05).At one year,they were 92.6％ and 86.7％ (P ＞ 0.05) for group A and B.There was 2 patients (7.4％) in Group A and 1 patients (4.3％) in Group B had severe incontinence three months after surgery (P ＞ 0.05).There was no patient had severe incontinence at six months or one year after surgery.There was a significant difference between group A and group B in the urinary continence curve (P ＜ 0.05).Conclusions Shorter membranous urethra lengths could be associated with slower recovery of urinary continence,especially for early recovery (3 months) of continence after laparoscopic radical prostatectomy. Key words: Membranous urethra lengths; Continence; Prostatectomy