Abstract
Between December 1991 and January 1994, 134 patients underwent radical
retropubic prostatectomy with bladder neck preservation. Forty-nine patients
had a positive margin. Number and location of positive margins were analyzed.
A tumor was identified at the bladder neck in 10 cases (7.5%). In all 10
patients with bladder neck involvement, a tumor was also identified at multiple
other sites. These data suggest that preservation of the bladder neck during
radical prostatectomy does not appear to compromise the efficacy of the procedure.
Using a self-administered patient questionnaire, we evaluated the
effect of bladder neck preservation upon continence in 36 patients. At the
initial 3-month follow-up, 24 (67%) patients did not wear any pads. Another 7
(19%) wore pads occasionally, while 5 (14%) patients wore pads daily. To date
only 1 of the 134 patients has developed an anastomotic stricture. Bladder
neck preservation may aid in an earlier return of continence following radical
prostatectomy and reduces anastomotic strictures. It does not appear to compromise
the removal of the cancer.
