Last Updated: 2008-01-31 10:45:32 -0400 (Reuters Health)

NEW YORK (Reuters Health) – A nerve-sparing approach to radical prostatectomy shortens the period until continence is regained and improves long-term continence rates, new research shows.

Previous studies demonstrated that preservation of the neurovascular bundle can improve post-operative potency rates, but whether nerve-sparing surgery improves incontinence was unclear, senior author Dr. Craig D. Zippe, from the Cleveland Clinic Foundation, and colleagues note in the December issue of Urology.

To investigate, the researchers assessed incontinence rates in 152 patients who underwent radical prostatectomy with unilateral or bilateral nerve sparing or with no nerve sparing.

During an average follow-up period of 7.8 years, 27 patients (17.7%) were incontinent. Eighteen of 61 patients treated with non-nerve-sparing surgery were incontinent compared with just 6 of 66 treated with bilateral nerve-sparing surgery (p < 0.05). By contrast, unilateral nerve sparing offered no benefit over non-nerve sparing.

In addition to the type of surgery, patient age also affected incontinence rates; subjects older than 65 years were significantly more likely to become incontinent than were younger patients.

"This study suggests that all patients, irrespective of potency status and age, would benefit from nerve-sparing procedures when this is clinically feasible," the authors conclude.

Urology 2007;70:1127-1130.

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