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Year : 2013  |  Volume : 29  |  Issue : 4  |  Page : 338-344

Bladder neck sparing in radical prostatectomy

Department of Urology, Stepping Hill Hospital, Stockport, United Kingdom

Correspondence Address:
Michal Smolski
9 Goodwood Road, Marple, Stockport, SK6 7QW
United Kingdom
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0970-1591.120118

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The role of a bladder neck sparing (BNS) technique in radical prostatectomy (RP) remains controversial. The potential advantages of improved functional recovery must be weighed against oncological outcomes. We performed a literature review to evaluate the current knowledge regarding oncological and functional outcomes of BNS and bladder neck reconstruction (BNr) in RP. A systematic literature review using on-line medical databases was performed. A total of 33 papers were identified evaluating the use of BNS in open, laparoscopic and robotic-assisted RP. The majority were retrospective case series, with only one prospective, randomised, blinded study identified. The majority of papers reported no significant difference in oncological outcomes using a BNS or BNr technique, regardless of the surgical technique employed. Quoted positive surgical margin rates ranged from 6% to 32%. Early urinary continence (UC) rates were ranged from 36% to 100% at 1 month, with long-term UC rate reported at 84-100% at 12 months if the bladder neck (BN) was spared. BNS has been shown to improve early return of UC and long-term UC without compromising oncological outcomes. Anastomotic stricture rate is also lower when using a BNS technique.

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