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13 May 2007
New Procedure Minimizes Incontinence After Prostatectomy
by George Atkinson

A new surgical technique developed at the New York-Presbyterian Hospital and Weill Cornell Medical Center and reported in the journal Urology could rid men of the urinary incontinence that frequently occurs after surgery for prostate cancer (prostatectomy).

"Modifying existing tissues, our technique added only a few minutes to standard robotic prostatectomy, yet attained a 95 percent continence rate," said lead researcher Dr. Ashutosh K. Tewari.

Prostatectomy involves the excision of the prostate gland and adjacent tissue, but the procedure often weakens the ligaments and muscles that control the retention and release of urine from the bladder.

The new technique uses some of the tissues that would normally remain behind after prostatectomy to reconstruct the urinary sphincter and join the bladder and the anastomosis (the gap in tissues left by prostatectomy) with the surrounding structures. All up, the procedure adds just five minutes to the standard prostate-removing operation.

The technique effectively reconstructs the major anatomical players controlling urinary continence and the results to date are impressive. After one week, 29 percent of the patients in the study were fully continent and after six weeks that figure rose to 62 percent. After 16 weeks, 95 percent of the men had achieved continence.

"This is a real breakthrough in prostate cancer care, as a significant number of patients have post-prostatectomy urinary incontinence," said co-researcher Dr. E. Darracott Vaughan. "Too often, the threat of incontinence can be a key factor in a patient's decision for or against prostatectomy. A simple intervention like this could make that choice a lot easier."

The new procedure is not possible in all cases, however. The researchers noted that the men involved in the study had all been diagnosed with non-aggressive, localized cancers. "With more aggressive tumors, surgeons must often excise the tissues that we need for reconstruction, so the technique is not useful in those cases," Dr. Vaughan explained.

Related articles:
Three Prostate Cancer Treatments Compared
Sexual And Urinary Function Concerns After Prostate Treatment

Source: Weill Medical College of Cornell University

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